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Chi <br /> PERMIT PPI�QC, TIi1• 111n <br /> BUILDING/MECHANICAL/PLUMBING/SIMV/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 ADDRESS: � { ��- -- - PROPERTY TAX#i rRIT# --15041 OO1 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNERHICK P 121*- ('3e" Phone/E-mail <br /> Address l-1 ( l°3�--4EA `^ ?C City/State/Zip <br /> APPLICANT: Owner �Swner'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'Pia' (k1(l J(,j/\ State Lic.# 93 I(06'494' ( 1. City Bus. Lic.#0/ 6 75' <br /> • <br /> Address • Phone/Email <br /> TANS <br /> kE 1 CONTACT FOR PERMIT <br /> ;;�1I1 V►\ Phone/E-mail - 210 702-3 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK IiOa' <br /> Existing Use of Building 'l(k ' �� HEAT SOURCE: • <br /> Proposed Use of Building `e-- Gas_ ElectricA.- Other_ <br /> Building type: Single Family Duplex_Townhouse _. Multi-Family —Commercial <br /> Type of project: _New _Addition _Remodel `, s--Repair_T.I. Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the pack): • <br /> yhW116/''1 '14-- 0 a >. t i\lam s <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 /> • <br /> Water heater I Shower • <br /> , Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan I 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 drains ' <br /> Other I Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM . Other: it_A -i1`Ck b(.e. <br /> Number of Heads Other: -`%( 3 eip- <br /> I hereby certify that I have read",amined 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 whe. ti-.hereinThe granting of a permit does not presume top give authority to violate or cancel the provision of any other state or local law regulating construction <br /> T ,tom . e J� this property to perform the work for which application is made and I comply with the State Contractors Law 1 1.27 RCW and 296.200A WAC. <br /> Owner/Aute rized A•=nt Signature Date (Revised 4/2015) <br />