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Feb 20 2015 03:41 PM HP Fax page 1 <br /> CII(Lu fl� �- 0 ,j- <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERMEMOLITION <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 /> -_ <br /> LEGAL for new construction: Short Plat subdivision _ Lot No. (attach copy of long legal description) <br /> OWNER , r PhonolE-mail /��/J (— c[ <br /> Address 25Ze` , � �lti—J"�/�� Ak �Q O City/State/rp <br /> APPLICANT:—owner _Owner's Arden; Contractor �Cortractot's Agent _Tenant(must provide eei�tfwooffcan_sent from the owner to du w rk in u,n space) <br /> CONTRACTOR ���� �L Stta'teMLic.# � � (V 1 City Bus. Lie.# <br /> Address T \1,l,t �s � �TENANT B SI ESS NAME CONTA T FOR PERMIT <br /> ��.� ' �t��-� � �►-�\� �`fie�1��H�t�.vn��,ne. <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORD S& <br /> Existing Use of Building M e A 6f-7 A , HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: _Single Family _Duplex_Town house _Mutti-Family ,,SCommercial <br /> Type of roiect: New Addition Remodel Re air T.I.Sign Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <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 # m <br /> of fixtures Show Number(# of fixtures <br /> A/C–air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavato wash basin <br /> Water heater Shower <br /> Gas fireplace Kitchen sink$disposal <br /> Gas range Dishwasher <br /> Clothes Mer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heal 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 I SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hareby certify that I haveread end exam this application and know the same to be true and Correcl.AN provisions of laws and ordinances governing this type of work will be comp <br /> with whether spa ad hereti or not. gran g of a pprmH dopa nol prise me to give authority to violate or cancel the provision of any other state or local raw reg ulatirg can structlon <br /> That I am auth e y the owner prop rty 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 /> 20 J <br /> O orized Agent SI ure crate (Revised 9/2014) <br />