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0 0 <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: MU4 <br /> # P IT# <br /> C;113 v hhC k i� ��1� 7 o t3 200 7 a <br /> LEGAL for new construction: <br /> AShort <br /> �Plat/subdivision <br /> 'vl Lot No. (attach copy of long legal description) <br /> OWNER 6/ 7�-ti'`—'r`�� (7 — Phone/E-mail <br /> Address --2vj myh-qobkftCity/State/Zip r W � ?j <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 PER IT � ?)7 7•'S7bG <br /> �N ip-r, <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK kT31D <br /> Existing Use of Building � HEAT SOURCE: <br /> Proposed Use of Buildings,/ Gas Electric Other <br /> Building type: `&Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type ofproject: New Addition Remodel Repair T.1. Sin Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 34 <-, <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT hPPI ICATION <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 j Bathtub <br /> Gas piping Lavato wash basin <br /> Water heater Shower '�.. L <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 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 / 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 1 am authorized by the owner of this property to perform the [k for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> J _ <br /> lJ <br /> Owner/Authorized Agent Signature-- Date (Revised 4120-15) <br /> 8/2- <br />