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r <br /> 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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTYTAX# Z9051T3�r?zoB�F�o P RMI" <br /> o 0 14-l-, S4- Z,r--&e-V k)A 29o516002071ho <br /> LEGAL for new construction: Short Plat/subdivision Lot No._ (attach copy of long legal description) <br /> OWNER Lp02T dr z--t En7cc-'i Phone/E-mail 4-Zs-3?,6-06-04 <br /> Address 1220,5- CfRA-FTSMA'N VA &Su e_ -tea City/Stale/Zip Evllf vitt WA <br /> APPLICANT:-KOwner Owner's Agent Contractor _Contractor's Agent _Tenant(must provdealetterofconsent frmrntheovmertodov rkinthespace) <br /> CONTRACTORS u S L&I Lic.# COE Bus.Llc. <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Cre-1K (E-P`rlgC pve7 of—GLIE <br /> Phone/E-mail2 S- 3{j gj- ©(o D <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK T)3 1> <br /> Existing Use of Building ///JJ�dd HEAT SOURCE: <br /> Proposed Use of Building /VIA Gas Electric_ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project! _X New _Addition Remodel _)(Repair_T.I._Sign Sprinkler ADemolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> EV,fOE7'r S0,P`(ICR(S St Tc 1*17TCA O e r AIVP t}e-hON I�t'� CE V7-R�A w /�•?2rl Tft NP2oc/v ciGS- /0;74 s� Z <br /> 'YNCLt1DfNG IVEW RULICtGAa AN-6 V1r-WiN,4 City Cyn (t�so2) /t7c�Olace,Merrf� S7oPM <br /> Dff/',t i Rt1D WATCZ;� Lff,,M 1.40bJFJCATtoNs, MgieigE biZM0Li7 �nf A'k/b 5E'JfP1ZJV7' A,eedj tq) <br /> tetI- CL.EAfJUP ljtN� TcMPo(?gE-Y I=ENcvtiG � WA.Lk.WAY , EE PRO�CT bkAvfiNC- SEr`, <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 /> Forced air systems Bathtub <br /> Gas piping 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 Sink(service/bar/mopfetc.) <br /> Heat pump 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 forwhich application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/Authorized Agent Signature Dale (Revised 6/2012) <br /> Z <br />