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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 /> 7-7- 16 1 z 3 ,t►► ! SE' E JEj¢.ETT wsr 19.00 p a 214 0 0 o o 0 o o C150-1 (�V <br /> LEGAL for new construction: Short Plat/subdivision Lot No._,- (attach copy of long legal description) <br /> OWNER �eM e( r� AP. el Phone/E-mail r 05,crt e rh ec( M 41 C-.) <br /> Address 2 2 I Z `}l� L S City/State/Zip �V 12(�T7 p} $2�O <br /> APPLICANT:X 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 -r -r i'-_.- - <br /> L L-011 SSY c �r�.State Lic.# C t-T C 'E OCEJ City Bus:-L-iC.#- — n p <br /> Address� /�\i Com;o� RJB' N Sita 3.(�_.-�! �L-cl0 � -S <br /> Phone/Email �Q� _ -( ---- -. .C) %U�/`C /`J <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> LLcm,5 Te i ane Fevl Hcnq,c <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK d OCA = <br /> Existing Use of Building l�'M ph'i t�) ,F'\-� HEAT SOURCE: <br /> Proposed Use of Building C✓-"/- li*-n C-1 Gas_ Electric Other <br /> Building type: V, Single Family _Duplex_Townhouse —Multi-Family _Commercial <br /> Type of project: New Addition Remodel Repair_T.1._Sign_Sprinkler_DemolitionChange of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> fC) GSF � �Gr`f h�✓CiM <br /> �� I'�� S�`c� t-��`'c� «' ��j3-, � �'� c rrc�194tP� i►1�-Vlvr `->FctC� <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 /> i A/C-air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater i ! Shower <br /> j Gas fireplace I Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer i Clothes washer <br /> Range hood i Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater I Urinal <br /> Boiler Drinking Fountain <br /> i Refrigeration Floor drain <br /> Woodstove I Grease trap <br /> I Ducting ! Roof drains <br /> Other j Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM i 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 /> /-2 IS <br /> Owner/Auth iz Agent 8`iRjTrAture Date (Revised 3/2013) <br />