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• • <br /> 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: C IPROZWTAX#tozol A-hoor` eV>�� Qv;�r (02 Z� oloo3o Ssx� rrr�� <br /> LEGAL for new construction: Short Plat/subdivision ,+ Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail �p.(LA�'S1' <br /> Address � �( ?j�j t3 City/State/ZiP1* qU( Oo <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 uI9/ Q� /� �^/// froK State Lic.# z,&111�/ 1�'%- City Bus. Lic.# 02-70""t <br /> Address 'q/OZ $ PL MAI, A�fi�(, 0, klAf �8��� Phone/Email Zl�' - % �- f���/ <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �hti�1< r yu�, YGcTt/� >/-7 all <br /> Phone/E-mail kEAAAt./H/Ver 'W ""2. Com <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 7(, ' I M <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas ✓ Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Muiti-Family _Commercial <br /> Type ofproject: New Addition Remodel —Repair T.1. V/ Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back):1tas�oA 0) -1,5 ko--�i2Tv w, P�S5CC,:,p,�-o> <br /> �vC,r az- ¢e 'S\-bzs z�,a\ (�� 2. CL usl CAw, . -TJ S�-wl\ (4) tJNi�-�Eh\-�rtS <br /> C) <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 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 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 am a�by ner 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 /> �/3 <br /> Ow r/Auillred A nt Signature Date (Revised 9/20141) 1'] <br />