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BUILDING/MECHA��ICAL/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.evereftwa.org <br /> SITE DDRESS: PROPERTY TAX# Ton) <br /> � t-�>�f�a�s��✓ ��--�a —fel <br /> LEGAL for new construction: Short Plat/subdivision Lot No. {attach copy of Ibng le <br /> OWNER A tJ'/J(4O0r#A7C1'Ut&-s Phone/E-mail <br /> Address [ej (�, t t rty( �j� City/state/Zip a�Uit( LIk� ,ell OZ <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 V � �� � ZAr �� �CT1�C— State Lic.# F_VbC5 0Z2-b l City Rus, Lic.# ljG"7z` <br /> Address 2t-0 PC.-tkC- N )G, V—J u,t.A q 9 D 1 Phone/Email 4 <br /> TENANT SUSINESS NAME— CONTACT FQR PERMIT <br /> Phone/E-mail - <br /> �'LS-Z I <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electrics 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 /> R�12 I t( 3, q t 7 q'," p•. PAcU4600 e-toart PLixp) , P- P101tAJG <br /> Ulu •4-SW f NOGG- �tf�'-101/ALt Svc f s its/ s � �4 �z'� S A��KIS`17�t1 G, Nd C' J6t5 �' <br /> bu ct we.V L ,-r Locyt� <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 /> NSPRIForced 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/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 /> NKLEIR <br /> Ducting Roof drainsOther Medical Gas <br /> / SUPPRESSIOM 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 whelhe 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 a auih ized by the owner of this property 10 perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Date (Revised 4/21715) <br /> Owner/Authorized e t Signature 1, �c / <br />