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OPERNT <br /> BUILDING/MECH °,�\ICAL/PLUMBONG/JSIGN/SP RINKLER/DE-MO TION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wvvw.everettwa.org <br /> SITE ADDRESS: PROPERTYTAX# PERMIT; <br /> Z13 ( W : yra.3y C ' ' <br /> LEGAL,for new construction: Short Plat/subdivision Lot No. (attach copy of Ong legal description) <br /> OWNER -W ETAiCrt t ///Z!�( �� l fr 1�L�Z C Phone/E-mail 2`7— O q^ :;-o(3 <br /> Address L City/State/Zip 'V cv-r W'4 4434:/ <br /> APPLICANT:—Owner _Owner's Agent _J_,'Contractor _Contractor's Agent _Tenant(must provide a letter of consenl from the owner to dp work In the space) <br /> CONTRACTOR C'(� �( ZC�Lti ��&i rfLJn C- State Lic.# City Bus. Lie.# 00-7419 <br /> Address 2-k-2-o oCiaC N)C--. . �V%l2txT. L'4 qozot e/Email LZ�r ' 2-�,;2 j( 0 <br /> TENANT 13U,9119ESS NAME— CONTACT FOR PERMIT <br /> 4.751 2, -i/!q tot A Gtk <br /> n Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of BuildingHEAT SOURCE: <br /> Proposed Use of Building 'Y® ct f �. Gas_ Electric other_ <br /> Building type: ^Single Family _Duplex__:Townhouse _ Multi-Family X Commercial <br /> Type of project: _New —Addition —Remodel Repair_T.l._Sign_Spiinkler_Demolitiorl_Change of Use <br /> DESCRIPTION OFWORK(additional space provided on the back): � <br /> 2j , 41�Z'a ,� tfr <br /> --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 /> A/C-air handling units Toilet <br /> Forced air systems 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(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I Ducting I Roof drains <br /> Other Medical Gas <br /> SPRiNKLER /SUPPRESS110H 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 /> QwresriAuthor Agent Signature <br /> Date (RevJsed 4/2095) <br />