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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# PE IT <br /> 2- u. <br /> - ����.:� �,y ( �c.v4}� LC`61 GCy ? �I 1 ll`1(''�'1C�1 a1113'>L <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER -ee.r, C c Phone/E-mail <br /> Address W& tk;lL rvt C J P, r14 -t V:�'q u City/State/Zip p�L��lil t� l l_ &00 t� <br /> APPLICANT: Owner Owners Agent _Contractor Contractors Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR "%jrlt 6 5Y S bu kf—Sf ((P� State Lic.# ('l 5��t (`t l3t?1 City Bus.Lic.# 0,A `1( J <br /> Address �t `�- ( 1 -.�+2t t. AJ �j Sk t:. Q411 L LLA J r>`j'� Phone/Email <br /> TENANT BUSINESS NAM CONTACT FOR PERMIT <br /> UJ alyrcleh"S S'o Ak -A- -11-1 O Phone/E-mail a57-,2, — 0� 3 3—VL-q G��1..�1 A) i vw f w ���•w•11 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Z�� `11 6 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ Other <br /> ✓C _ <br /> Building type: Single Family _Duplex_Townhouse Multi-Family /ommercial <br /> Type ofproject: New Addition Remodel Repair T.I. Sin rp rinkler Demolition_Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> r-5w 1) I'L�6 �t'tJ ddr�rh} �tidiS�� Srlrtn k-Levi (cC�H+ ,�c 7Tt� /ue - <br /> CAd V11 . RevYn Cetlkyj A"J13. <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 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 compl <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 /> Owner Authorized Ag n ure Date (Revised 4/2015) �,, <br />