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14 <br /> i'ERMIT APPLICATIC ;,v <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SP RINKLER/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# ERMIT# <br /> -i C1 3, �SeAkwz,yf- Ave_ h ti QCC � OG ` i <br /> LEGAL for new construction: Short Plat/subdivision Z18 2.`13 Lot No. (attach copy of long legal description) <br /> OWNER O KC) �" ,t ��� 'I1 C J`O h r)���1 / Phone/E-mail <br /> Address 'Lf(1� I L4-h U 25+ �V Z , G VW 11 City/State/Zip <br /> APPLICANT:'N� 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 )( rJ/i jl�. State Lic. # City Bus. Lic. # _ <br /> Address Phone/Email <br /> TENANT BU51NE55 NAME CONTACT FOR PERMIT <br /> Phone/E-mail ftl(,j 00 PR W Q-C <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4 �,7q 2D <br /> Existing Use of Building r�l'1 ti/L ileCIS(r-1), HEAT SOURCE: <br /> Proposed Use of Building�/ G M l��� RPS iC] Gas < Electric_ Other_ <br /> Building type. �(- Single Family _Duplex_Townhouse —Multi-Family _Commercial <br /> Type of project New _Addition Remodel _Repair_T.I._Sign_Sprinkler Demolition _Change of Use <br /> DESCRIPTION OF WORK(additional space prow d on the back): <br /> W l f U Z o-lCr+,/ H P 1 >�,Ptit<� l <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 /> I A/C–air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater 1 ! Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan j Sink(service/bar/mop/etc.) <br /> Heat pump I Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler j Drinking Fountain <br /> i Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting f Roof drains <br /> Other i 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 complied <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 t is 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 /> caner Au rized Age Signature Date (Revised 4/2015) <br />