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irr <br /> HERMIT APPLICATICdd <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 /> f //U ' zs 5 i .l/% , S./4"4 <br /> SITE ADDRESS: PROPERTY TAX fl P RMIT# <br /> /51.2:7i - �c— . GE IDN-6 v 9 <br /> LEGAL for new construction: Short Plat/subdivision Lot f'115. • (attach copy of Ibng legal description) <br /> • <br /> OWNER �cd___41//� Phone/E-mail ,1 CV) "225 -'.'c'52� r� <br /> Address _2/5 i5 of S S7-• City/State/Zip i_c/ .'44 .u4. A'`4 /5C? <br /> APPLICANT:_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 S 72:6"/ G.P.,,S/�2e.t c 0n Z...4--' StateilLic.# CCS EF/CLget)Qfi City Bus, Lic.# (J (pj'S l <br /> Address pee gc9/� l y�2 /A/k/174- -c y8Z7s Phone/Email <br /> CONTACT FOR PERMIT ,7� zj ' <br /> • <br /> 7 S--...2...39-- S' 7S ci) ( 7 c.t3 . �/,�� <br /> Phone/E-mail ,�c t5/Lt c kefrr <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ' .S" WO •`)`' <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building 25! Gas Electric Other <br /> Building type: >4-Single Family _Duplex Townhouse _Multi-Family Commercial <br /> Type of project: / New _Addition _Remodel _Repair T.I. SignSprigkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 5 ,,9p.E7 to A471,-) ,, 69,14-ef-c icsi/LEe/' 11+7 ,'A /*----749"/".-k-- <br /> ‘b <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 /> • <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 I Grease trap <br /> Ducting I Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other:19 /p c/../S24.941( <br /> Number of Heads Other. b 1 -*r!L <br /> I <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 peeerfformmtthe work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> C -i/ 714/ -el. al,,,,, <br /> Owner/ thonzec'Agent Signature Date (Revised 4/2015) <br />