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PERMIT APPUCATRAq <br /> BUI LDI NG/MEC ANA CAL/PLUM13,NG/SI GNISPRI NKLER/DEMOLIT ION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> PROPERTYTAX# PERMIT <br /> SITE ADDRESS: ��-el� /7 �s �c� p fjG' ! C'o <br /> _/ O <br /> LEGAL for new construction: Short Plat/subdivision Lot No.�,,/ (attach copy of Ibng/legal description) <br /> OWNERl �y <br /> lao Adklh � a�� �L1 ``ode Phone/E-mail -e/-Z s -/ <br /> Address- 3 Z- G (>L�r fi�� CitylState/Zip / <br /> APPLICANT:fCOwner _Owner's Agent ^Contractor _Contractor's Agent _Tenant(must provide a leiter of consent from the owner to Op work In the space) <br /> CONTRACTOR &v rt eA State Lic,# City Bus. Lic,# <br /> Address Phone/Email <br /> TENANT-BUSMCONTACT�-F1*QR PERMIT <br /> zs-vyr <br /> Phone/E-mail Gz�.�,cy� ;.1� <>�'/`1�``s�'��j 4r'�' e <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building s HEAT SOURCE: <br /> w Gas Electric of <br /> Proposed Use of Building <br /> Building type: C/ ingle Family _Duplex_Townhouse _Multi-Family Commercial <br /> Type of project: _New e-<ddition —Remodel _Repair . T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DE= CRIPTION OF WORK(additional space provided on the back): <br /> l'3 ti;/� �'�o . �'t �4 h�j z <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type o roject: jG14ew_Addn _Alteration_Repair Type of Project: _.,New_—_Addn _._,Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of textures <br /> A/C-air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Layafory(wash basin). <br /> r Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> 'Cas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Rangestlood Water heater <br /> Exhaust n Sink(service/bar/mop/etc,) <br /> Backflow preventer(inside bldg) <br /> Heat pump <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> J Ducting f Roof drains <br /> Other Medical Gas <br /> SJPJRINKLER I 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 <br /> authorized bytheowner 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 /> Date (Revised 4/2015) <br /> ownerlAuthorized Agent Signature r <br /> � L <br />