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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 ADD // 7,-/`f/ J2. _ ` �OD�TYTAX/t)0000 5-= c PERMIT# <br /> 7 L' 9� � � MIT ` Uf 7- <br /> LEGAL for <br /> new <br /> s construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER G" A , /J�,OL J ,..46/7--#4/// y Phone/E-mail X7,, <br /> x Address �C c' / 5e 7 City/State/Zip ///v 7(7 Ayr' 9fZC2 <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 68/ State Lic.# City Bus. Lic.# <br /> Address (Phone/Email <br /> TENANT BUSINESS NAME e.:75-0// s c.5-6 CONTACT FOR PERMIT�T5 <br /> Brea- /�C- jCa Phone/E-mail (i/Z.--C.5-60 :6'39z> po/tv`Y ec-17/o, (MZ , <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK AyL ,, <br /> Existing Use of Building ':). HEAT SOURCE: <br /> Proposed Use of Building / Gas Electric Other <br /> Building type: Single Family Duplex Townhouse '«�Multi-Family Commercial <br /> Type of project: New Addition Remodel Repair T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> eltyr <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 Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood ,3 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 Other: <br /> nNumber 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 comp) <br /> with whether specified herein 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 Ia Airon ,by t,- .wner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> //- V-/y <br /> Owner/Auth) /.'Agent Signature Date (Revised 9/2014) <br />