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PERMIT APPLICATION <br /> BUILDING/MECHANICA L/PLUMBING/SIGIll PRIN KLER/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: fv�`_0 7 I vere14 mQ i VJ0, PROPERTY TAX t# PE,12A111 # <br /> 1. bl <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:—Owner _Owner's Agent t Contractor —Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR Q nJ T SK SP 1 V iC State Lic.# 13 j5 i S `99 CJ PQ City Bus. Lic.# <br /> Address f�C�I� �0 4eII-E1f?/Z. Mtll Gee L WA ggbr� Phone/Email #25. 330 SibO r%tits tc�v11>1Snc r► <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> e-1 II nb Ct C C o Er un l <br /> �/ � <br /> V�. / Phone/E-mail ��5. �J30•�S!�+� 6�G'G fiS tyv�s p m�n ���►1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 9 f (500 <br /> Existing Use of Building Comrre.r-C tc6 HEAT SOURCE: <br /> Proposed Use of Building NIA 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 /> �D Jnr \ I�kler s�j� -f��jl� . - �G�� si�Yl <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 /> I Forced air systems I Bathtub <br /> j Gas piping j Lavatory(wash basin) <br /> Water heater j Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range j Dishwasher <br /> Clothes dryer j Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> j Heat pump i Backflow preventer <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 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 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 /> 1-) 0 1 0 - 0 q <br /> a-, <br /> `l <br /> t I tv <br /> O e uthorized Agent g re ate (Revised 3/2013) <br />