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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 /> r <br /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> rs �/IA�tNml.lA AVG c5�3,3OA iromo-opt <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER A,06JQtt WA4,f-� Phone/E-mail3C,—t1-g5�+p <br /> Address 15 k NaLI A AVC- City/State/Zip W Q •-d o �-� <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 ., (4",0AAJ�G AN/ 1tate Lic.# 1 600bACSafo3T9 City Bus. Lic. <br /> Address f Z12-71144JA/ wA -7go / Phone/Email '-J245- '1J'1-J46.4) <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT &ft-tbA n/LC9p Nq/- Z M6A✓ <br /> / Phone/E-mail ti/1-+4,/ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK '-�-70 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building SFA— Gas '� Electric_ Other_ <br /> Building type: !/rSingle Family Duplex_Townhouse Multi-Family Commercial <br /> TviDe of ro ect: New Addition >e-1,Remodel Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): 4 AS <br /> `MS-TALL-1,✓& A (gAr FrA-2ALAcr— �eL7 �/�v�v0��4 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn XAlteration_Repair Type of Project: NewAddn _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 <br /> 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 /> i 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 spsOfrd 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 aux iz by tie 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/A horized Atent Signature Date (Revised 4/2015) <br />