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PERI, RIT /kPPU CATI A <br /> UIQ.®IVIG/MECH " CAL/PLUMBING/SIGN/SP III LER/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 /> . <br /> PROPERTY TAX# P EMIT# <br /> SITE ADD/REBS: `i O _ ' 17,--0' <br /> ` – <br /> LEGAL for new construction: Short Plat/subdivision Lot No, (attach copy of long legal description) <br /> OWNER tai, A fi'1 Phone/E-mail `i<2;,2.5-y ".' )j key—e94 ,Zfr•an-he-L-• cebi <br /> Address i//,-j '"7/ f-/, ST City/State/Zip Eve.;-c, + r :: - <br /> APPLICANT: X Owner _Owner's Agent Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR 1 �/ State Lic.# City Bus. Lic.# <br /> Address • Phone/Email <br /> . , :1 1 r . r CONTACT FOR . <br /> �/ PERMIT ) <br /> Phone/E-mail `r,,t• `2-7 ' kG1'{e-7,a-D-t-y6✓rtwY,01, <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building.1)74/--a HEAT SOURCE: <br /> Proposed Use of Building •S'T0VG f4-i cr�• — 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 /> • <br /> 0Ylcv1c , <br /> _chee-711//15 fres/Lr r7 0/� . rh 4-- eirpt PIIfnir-c 5 �-� e'vd/ iiM -{L <br /> �sftGG-17 'e ' e —e s— ' l*7G <br /> /el-- ,/ <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 rangeDishwasher <br /> Clothes dryer Clothes washer <br /> { Range hood Water heater <br /> { Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat pump Backflow Preventer(inside bldg) <br /> Unit heater Urinal - <br /> BoilerDrinking Fountain <br /> { Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting I Roof drain's <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 complied <br /> with whether specified he,in 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 b the owner of this r,o,,P-. •perform the work for which application is made and I comply with the State Contractors Law 18.27 ROW and 296.200A WAC. <br /> Gi 2076; <br /> Owlier/Autho ed Age ttigndture at/Ve (Revised 4/2015) <br />