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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 AD72-DR / PROPERLY TAXd z)n L' J 6/ PERMIT,14 I I .f 9 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description)/I <br /> OWNER 6747,C7/- A)eisiA/6 Airhafry Phone/E-mail Y..5 G5-8... elZ .g.•2-- <br /> Address (, 'X /Je / City/State/Zipv 6� A/f7 -02ZO6 <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 6M2 (State Lic.# City Bus. Lic.# <br /> Address IPhone/Email <br /> TENANT BUSINESS NAME G 70// 6 i d J/ 6, 7 J CONTACT � RM <br /> FOR/ PERMIT7,04/ �� �� <br /> 4/ _- <br /> �7/,6'r->, �;, Phone/E-mail 7�S.J ile/.,6.i 'cie> d G' r.. <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /969J.C`-D <br /> Existing Use of Building 4:5",;<- HEAT SOURCE: <br /> Proposed Use of Building Gas VElectric 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 /> C,4,11/6'?;:— r1YT /V/1% /� ' /' r � . <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 /> A/C-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 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 /> 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 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 I)rii'o�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 /> �� .7f� <br /> Owner/Auth) j Agent Signature Date (Revised 9/2014) • <br />