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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 /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> f�10 1(34f� S S • � 0V5'*75Zvo( oo4- 0o 31 /Z 03/v <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER IPAV& eALEV Phone/E-mail 14L S - 3 3 - 7 3 <br /> Address < S - City/State/Zip 6 V,- " f—— Z d <br /> APPLICANT:_Owner _Owner's Agent _Contractor _Contractor's Agent: _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR (—P—LIC 6-0 4 A 55 LLL IState Lic.# (,C(.16�,�('" ?U City Bus. Lic.# (y � <br /> Address Z-C 1 (i— . S`7. SCJ A14J?U d (,,f fW Phone/EmailZV,? e131 ..`J'jO <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Kr-VdA! f�'- MLD -S"�3 70-9 /o -7z- <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /5?%� oeo ' <br /> Existing Use of Building /'I J,4 ' HEAT SOURCE: <br /> Proposed Use of Building N6&J vJ L.F_SS 4 Gas_ Electric . Other_ <br /> Building type: Single Family _Duplex_Townhouse _ ulti-Family Commercial <br /> Type of project: New Addition Remodel Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> -t'til S 77�� Nkw CJI P_6 L f-!a F7-?-�u7t Z 3r 6 r FrE..I -xA s r, Ate, meq- �rYh <br /> AM56v 77u /-fOAJOPci-E , A rA /6 X IZ ` Fc i t t F, s s444-77E PQ- <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 airs stems Bathtub <br /> Gas piping Lavatory wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas ran a Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <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 comp) <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 /> Owner/Authorized Agent Signature I Dat (Revised 9/2014,1 <br />