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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 /> 5L4I VC- 101 <br /> SITE ADDRESS: PROPERTY TAX# PFPIVIIT ff <br /> t 33 I 41/8 SC g.vc-/L c /030 6QaO folio° A/11 oq - 0(kJ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER I-eY f 1 Phone/E-mail <br /> Address `0 1,1i-. A\f � � City/State/Zip Eve y -e L. /1 <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 68/4 cp '4lJT l/)( State Lic.# CC a /•146,24.,6) City Bus.Lic.#as-3y--- <br /> Address 4(9..27- /f37°/ ,L S /...00 MX Phone/Email /96-674 K <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT ,J'4y CnILA-N I <br /> S'#/1 '4 /41-64-C171-- h(-1--- <br /> L , dty. 42S__ <br /> y.� <br /> t { y Phone/E-mail 42S_ 70a� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 27 500 <br /> Existing Use of Building C �' / 'f t'r. j( sel lv"n HEAT SOURCE: <br /> Proposed Use of Building > i'7 S7 Gas Electric Other <br /> Building type: _Single Family Duplex Townhouse Multi-Family X'Commercial <br /> Type of project: _New Addition 'Remodel Repair ' T.h.," Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional p ce provided on the back): IM t-'• K VW/VI' 44.44.1U er'• <br /> (2-e-kre C e R 4k) C . e -0 tee.. n 4.J,.,.A <br /> A . rb-i <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 _ _ 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 , _ RI ► — Medical Gas <br /> SP NKLER/ 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 l am authorized by the er of s property to perform the work for which appli ation is m a and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/Authorized Agent ignatu a Date (Revised 9/2014) <br />