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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 /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> 6605 rill Greek- P,,W11 �BoNoZoc) <br /> Mergo, (!)o (7-7® <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER S�J Q t VS A i1 + ^ Phone/E-mail <br /> Address'6 ZO3 121 s'AYG AIE Beii WA 1%0 19 City/State/Zip S,,4, e(( c J Q 1 ? <br /> O l 1 <br /> APPLICANT:—Owner —Owner's Agent -)L Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR DQ [SJ vJ� , e ti &)W State Lic.# DIM(-< 16–` - NRK City Bus. Lic.# <br /> Address 2 00 I W'"S� SCJ S„u 1S re- 02> Phone/Email 2 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> S tj Q L w-C A- D,v i k !s kr`er q7 a <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �N I2 Otho <br /> Existing Use of Building 3S� En�ir�ecfin� L&b 4- Aegtar HEAT SOURCE: <br /> Proposed Use of Building Gas T- Electric_ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family °�Commercial <br /> Type of project: New Addition Remodel _Repair T.I. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> AJ k Z in.i <br /> SP - . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_XAddn _Alteration_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 airs stems Bathtub <br /> Gas pipingLavatory 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 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 / 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 comps <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 /> Own /Authorized Agent Signature Date (Revised 9/2014) <br /> l-2— <br />