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PERMIT APPLICATIC <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 ADDRESS: _,,4 L .5(,c) ,Gaa94li(�00 0 13 4 r] Yl OPERTY TAX# 6o1 -()02, <br /> /yc .J AY p . <br /> LEGAL for new construction: Short Plat/subdivision Lot No. I (attach copy of Ibng legal description) <br /> LOWNER Jokyv : Lek yV\,GJ,,,,,, Phone/E-mail 014_, ,L vvt,4�y,_,1 c)O31$�1". PL 5 t;J <br /> Address)q03 9?4'k pi a„..) ✓e-Ye-iI (A)a.,• City/State/Zip E ikrYei., l��l l �a-o 4 " "Ll I <br /> APPLICANT: Y 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 State Lic.# City Bus, Lic.# <br /> Address Phone/Email <br /> CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building 110 me, HEAT SOURCE: <br /> Proposed Use of Building t-Acev' _- 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 /> H P -fi_,A5.€,ww. `I. 1 A e- .r -, e.-i S fi t--v- cUviInt i-wu /t,u .--�- � • <br /> P . LI 0w-LS c ) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New^Addn _Alteration Repair Type of Project: ^New_Addn Alteration,r 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 I 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 • i Sink(service/bar/mop/etc.) <br /> Heat pump [ Backflow preventer(inside bldg) <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 ( j Other: ik` ( jnu ,1AA-ilisT <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 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 authorized by the owner 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 /> (-- ,&.C. )S ''((i--- 7 -z- I S--- <br /> Owner/ALthorized Agent Signature Date (Revised 4/2015) <br />