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PER N T A P ll-"U CA U I U N <br /> BUILDING/MECHA�\aCAL/PLUMBING/SIGN/SPRINKLER/DEMOLITI®N <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: I# PERMIT# <br /> Soo oAc(,I2t CVeeL vpAvl�t✓ l('I .0 �Q <br /> LEGAL,for new construction: Short Platfsubdivision Lot No. (attach copy of lbng legal description) <br /> OWNER1 �JG/J � Phone/E-mail _y o (,- L <br /> Address Z'3 o O r .-A.iti(( C✓e C City/Statealp L;yGxrg <br /> APPLICANT: Owner —Owner's Agent _Contractor —Contractors Agent _Tenant(must provide a letter of consent from the owner to dp work in the space) <br /> CONTRACTOR Ev r C P—C� � TAT fLinw— State Lie.# LVF-1&550220 l City Sus. Lic.# 0c) <br /> Address 'Zv2'(D PC-I LC ox )G. V U,t q 9¢D( PhonelEmail 4 2a <br /> CONTACT FOR PERMIT <br /> �w✓��w�l Spy 2��-2,52-31/V l <br /> Phone/E-mail A4ArLK . r,- <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use Df Building 140 UA-X)Cr HEAT SOURCE: <br /> Proposed Use of Building jVv C_tAAVJ Gas Electric_ Other <br /> Building type: _Single Family _Duplex Townhouse __Multi-Family Commercial <br /> Type of project: _New _Addition _Remodel Repair_T.1._Sign Sprinkier_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 1(2-4 fZ T>At e- ul p p,/c {-v �wL) w 3t 3 c zt C44PAC-i <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration (L,Repair Type of Project: _,New_Addn ,_,Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas 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 ISink(service/bar/mop/etc.) <br /> Heat pump Backflow 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 /SUPPRiESSION SYSTEOther: <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 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 /> "l'© 5 27/( 6 <br /> 0�—M ,4uthorize gent Signature Date (Revised 4/2 <br />