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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE DRESS: y PROPERTY-TAX/# P,€RjVL c '✓O� <br /> 660 U� 7 Q,7 i0y 3VLfeJ J i ti I.LF <br /> LEGAL for new construction: Short Plat/subdivision Lot Nc. (attach copy of long legal description) <br /> OWNER G F r z,tz—5 Phone/E-mail Y-)-)61, ; I C cr•-`t <br /> Address ✓47 61 U41 5 City/State/Zip (_,L-1() ZCJ <br /> APPLICANT: Owner ,Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR . (72(2t%g2 5 N-7•T 774,-,V, State Lic.# a EV'L i c 15)1ity Bus. Lic.#L�`J� U/'N <br /> Address 0 i 4? - 7 3 Phone/Email (•-• :.,.0)e,,,,_82.4 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> 004414 -1(-2-CZ--c0 Fevi <br /> Phone/E-mail (4-2�-7 4 j 7r�j�.'c <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORF'7O�C � <br /> Existing Use of Building &f".-12., ,„�<� 9v --� /�it7 J HEAT SOURCE: <br /> Proposed Use of Building 74 7\) Gas Electric Other <br /> Building type: Single Family __Duplex Townhouse XMulti-Family _Commercial <br /> Type of project: New Addition x Remodel Repair T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION�OF WORK(additional space provided on the back): r <br /> Ce)!1 tJ�'t 8k ere -710- <br /> FJ <br /> 7 ( L( L t <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project:.?‹..New_Addn _Alteration_Repair Type of Project: ?<New_Addn Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC-air handling units 1 Toilet <br /> Forced air systems I Bathtub <br /> Gas piping t. Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> Gas range I Dishwasher <br /> Clothes dryer ( Clothes washer <br /> Range hood V Water heater <br /> Exhaust fan _ Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing this type of work will be compt <br /> with whether specified-herei or not.The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I am authorized by th owner of this property to perform the work forwh'ch application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> IA �/ <br /> Ovcrrtgr/ rize ent tgnature Date (Revised 9/2014)k h <br />