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IERMIT APPLICATIOS <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 /> Ave- MILIOCI <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER D('. r-.,vcsS Yr'V 43 LLL Phone/E-mail <br /> Address ! lo,) f�l�(. ,2 lk-e- City/State/Zip F t,�1,46Z- <br /> APPLICANT:—Owner _Owner__sppAgent _Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR � r�fY► (� State Lic.# F-1/F-(Z 64ZL- (5,+I2ZCity Bus.'L/ic.# <br /> Address �'Z� ✓1 f ' l�lZm {c �./ L( 31.b�, Phone/Email zoo -�3 n f`�' <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> rtnPhone/E-mail 7a , =16D -(-1 f y r..,t,52-Y 7 Z� et��✓ _w . <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4 &` t0,j •0.;� <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ 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): �I /dL <br /> ffirers <br /> :;—�,v��I,{,I s✓�N� 1 +.to C��, ,met�t u� t �S, c�✓!i�wu✓�C- t U' <br /> , �,^�, Czar - - <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn Iteration_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 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 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 comp <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 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/Authorized Agent Signature Date (Revised 9/2014) <br />