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„do <br /> PERMIT APPLICATIO. <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 /> c(k. e.\O` <br /> SITE ADDRESS: I O 333 I Tk'Vl Ave C PROPERTY TAX# PERQIII, # <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER ) l/ Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:_Owner Owner's Agent Contractor i( Contractors Agent Tenant(must provide a letter of consent from the owner to do work in <br /> Q Qthe space <br /> ) <br /> CONTRACTOR Cc uAiNA-7 State Lic.#(_A .yc C(6?_yylj City Bus. Lic.#6 9212 ( <br /> Address S4 -+\12. ,\� Q Phone/Email ZO6 - 2,2 <br /> W`569 <br /> TENANT BUSINESS NAME/ 1^ CONTACT FOR PERMIT <br /> /t,2o6(� 2132^I,, S G q <br /> ay..-c� kl.lti� ,\ Phone/E-mailC l 'LA10CG\(.lt(1�V .Y1e� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <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 XT.I._Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): •c.-) u1/4.. •,,11.� 5 a I! L hn ebb,. �1,�,(_ -�(O <br /> �e.� nova.A C f L��S* �-3 CQ,' ,w h ✓ 1� <br /> 5. , 1).?C;34 S SIe yt ;h WaC(\Gan e,c11 - <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 /> • <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 /> 2. ( 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 am authorize. • e owner of this pr'perty to piriotr/qt work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> � -� ( LI <br /> Owner/Owner/• thoriz•. A,rJ rgnaturt Date (Revised 9/2014) <br />