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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#©A VX-,5 AVE- 1cc:,4-JqQ- -11#r5oZ - 400 PERMIT# <br /> LEGAL for new construction: Short Plat/subdivision E.V EZ.LA-NQ L° Lot No?Lq Zr (attach copy of long legal description) <br /> OWNER �C 0-TT PI.Iz'CC 1 1�- Phone/E-mail ZOCp Z Z.'1- '7!'27 <br /> Address City/State/Zip <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 State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT ij gr g c O <br /> Phone/E-mail ow 0 E4?— 7-27. 734 7 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK G <br /> Existing Use of Building 17HEAT SOURCE: <br /> Proposed Use of Building r7� - - Gas ''�Electric_ Other <br /> Building type: ✓Single Family _Duplex <br /> 7—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 /> t�F-Nr0VQ-Imo,. t x. N0 -�M�C! CnF-7- !K1 LOT COVETp-ACE." <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(#)of fixtures Show Number(#)of fixtures <br /> A/C-air handling units Toilet <br /> Forced airs stems 2 Bathtub <br /> Gas piping Lavatory wash basin <br /> ( Water heater Shower <br /> Gas fireplace l Kitchen sink&disposal <br /> Gas range I Dishwasher <br /> 1. Clothes dryer I Clothes washer <br /> Range hood meter--mater = <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 /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER I 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 specked 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 6 a authorized b('�Jy the owner of th property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br /> Y \ ► l V , . / Lam✓`� <br /> Owner/ uthorizedRgent Signature Date (Revised 412015) <br /> Gam/ _ <br />