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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: PROPERTY TAX# PERMIT# <br /> 2,1 W Mvk;14el &VA . <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER O uv' raa-4(6(�, Phone/E-mail C6wtcc6k Y,,J <br /> Address ($ \,JMJI4"(leo t3Iva- City/State/Zip L—: -A , 1^/A 18203 <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 Gerte.ro►l Gor\NC e Ors U,,, L& I Lic.# COE Bus. Lic.# <br /> 1 <br /> Address 'ZI 10 5at^ Phone/Email y?-s- <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �v� Sa v i ers Lv-I rave (��►Urc 11 c5wv i� c-6,is.YaeF 6hHareh,usw� <br /> Phone/E-mail A+ZS-ZS'I-C) (o <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK -* 1,Z M(1);ova <br /> Existing Use of Building Crhus<,i . HEAT SOURCE: <br /> Proposed Use of BuildingGas V-11 Electric Other <br /> Building type: _Single Family _Duplex_Townhouse —Multi-Family _Commercial <br /> Type of project: New Addition _Remodel Repair V T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> CY�c.lose e-X�S�tYtc GBJI��^'yu!'c� S>�C.G� �o G('�0��'e c� G1SV�fea f�wlr'YlaY1S S�.1GiGe <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 air systems Bathtub <br /> Gas piping Lavatory (wash basin) <br /> Water heater i Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> f Clothes dryer j 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 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 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 /> 8 <br /> Owner/Authorized Agent Signat a Date (Revised 3/2013) <br />