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CITY OF EVERE`YT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SIT4DDRESS: PROPERTYTAX# P Mr <br /> T# <br /> L l 15�1� O o "(p <br /> LEGAL,for new construction: Short Plat/subdivision Lot No. (attach copy of Ibng legal description) <br /> OWNER C(, ,ga Ve Phone/E-mail 2U0- - l Z2 <br /> Address R0, 5o)c 25(pq City/state/ZlUJA Q8Z/3 <br /> APPLICANT:—Owner _Owner's Agent Contractor _XContractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR L/ � '(� - 1�-�JWVC- 1�C� Ub`VV— State Llc,# F-\)bCr650Z2-0`l City f3us. Lic.# e)o 1eJ55 <br /> Address D-2-0 (-xc-tr-v- {-)e. l{;�Dag . u,-A q O D( Phone/Email 4 Z'� 2-G'2 110 <br /> Tff CON TA T FOR PERMIT <br /> tA0"(?C55 W,4 .C.OM <br /> lJ(�IVR.ISE SE2000Y� Phone/E-mail 2,5- 272-- <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK (Q,OC)D <br /> Existing Use of Building N0 P 44�Gif HEAT SOURCE: <br /> Proposed Use of Building NO �66 Gas_ ElectricL_� other_ <br /> Building type: Single Family Duplex_Townhouse _Multi-Family 1( Commercial <br /> Type of project: _New _Addition _Remodel 1( Repair_T.1._Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> MECHANfCAC PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Addn _Alteration �. Repair Type of Project; _New_Addn ,_,Alteration_Repair <br /> Show Number(#)offixfures Show Number(#)of fixtures <br /> A/C-air handling units l'oilet <br /> Forced 'air systems Bathtub <br /> Gad 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 Backtlovv preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER /SUPPRES SIIOM 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 compiled <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 a thorized 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 /> QwwwMuthoriz A ntsignature Data (Revised 412015) <br />