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PERMIT APPLICATION <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 /> 'r Ir\ \ L20'37-01---1 <br /> :SITE ADDRESS: PROPERTY TAX It PERMIT# <br /> - ?� a te'o s-i- s k o os2)�J oMO Yia0 a t--0-0--3-- 0 1-to - <br /> LEGAL for new construction: Short Plat/subdivlsion "//4 Lot No, (attach copy of long legal description) <br /> OWNER Oalfifi <br /> " I� ti'j'1 4- n 14VJV Th rtPhone/E-mail (14c'. 4 Z 2-367.'5 G� (� <br /> Address 1 b N riLXy c jv ,g CitylStatelzip //& b <br /> APPLICANT: Owner Ownor'sAgent Contractor Contractor's Agent Tenant(must prcvideaalatter ofcor._entfrom tr,aownertodo,•,rorkintheeoeca) <br /> CONTRACTOR <br /> �{C�} letr-�'(,,{r_ tJa 60.4'1' 61.4.4 �6yi ,State <br /> �Lic.# C 44 aL N 6$5�-✓�O iit�f Bus. Lic.# L • <br /> Address l 6 / L L��{'/f��7 14 'f 244 i// 4ot+>,a C/J2hone/Email pleo�7 T 7 et y=(Qd jNt ri.,.0c1,-. <br /> TENANT SINESS NAME CO ACT FOR P FZ <br /> r-lip <br /> Phone/E-mail A t;( S C( 4 Ae1/� 246- % / <br /> d <br /> . <br /> BUILDING PERMIT APPLICATION . CONTRACT PRICE OF WORK 4 1 .� <br /> Existing Use of Building / HEAT SOURCE: /J!4 <br /> Proposed Use of Building 0 GG U10et, 2 G9 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 /> waler da4nr,ei,6 r Cur We oil dui/-ec /0e6c cd ® ) <br /> /00 bf-5w at:466i1<;Iccs pgrryikk4i <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 CIO 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 /> i Water heater l Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas ranee Dishwasher <br /> Clothes dryer Clothes washer <br /> / Range hood # ry ic,N4taVe.. Water heater <br /> Exhaust fan I Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> i Unit heater Urinal , <br /> Boiler _ Drinking Fountain <br /> Refrigeration _ Floor drain <br /> Woodatove Grease trap <br /> Ducting [,tn./aley j df4C17 j I Roof drains <br /> Other { Medical Gas <br /> ' SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> Number of Heads Other <br /> I hareby certliy that I have read and examined this application and know the same to he true and correct.NI provisions of laws and ordinance:,governing this type of work will be comp: <br /> with whether specified hcrcin or not.The greeting of a perrnii does not presume to glue authoflty to violate or cancel the provision of any other state or local law regulating construction <br /> That I an Jt.. ed by the own= .f 1hl.fto perform the work for which application is made and I comply with the State Contractors Law 8.27 RCW and 296.200A WAG. <br /> 5t <br /> Ow uthoriz ent Signature Date (Revised 9/2014) <br />