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• • <br /> PERMIT APPLICATION <br /> BUILD[NG/MECO° ANICAL/PLUMBIN G/S IGNiSP INKLE RIDEMOLITIO <br /> CITY OF EVERETT FERMI SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 "rVv.everettwa.org <br /> SITE ADDRESS: I1804O'5OQ,4__JQ <br /> OPERTY TAX# IA 11 # <br /> t,2 1 <br /> LEGAL for new construction:Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> 0WNER�olJ1 R1IU1r� i 1A11ASt LLL. Phone/E-mail <br /> Address �j$� �02! City/State/Zip v m� <br /> APPLICANT: Owner Owners Agent Z Contractor -Contractors Agent _Tenant(must provide a letter of consent from the owner to do work In the space) <br /> CONTRACTOR SII'!/ �v a /� rf ¢root state Lic.# aA//V�'/ / !Cr'f= City Bus.Lic.# 02704/7 <br /> Address "'11107— $ p f-� /(/A✓ A (a"s-,, (IA� 7800/ phone/Email Z <br /> TENANT BUSINESS 1NAME CONTACT FOR PERMIT <br /> _ Phone/E-mail �% GJyI{�C i^r .God <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building OWILLL ;ae HEAT SOURCE: <br /> Proposed Use of Building W'L Gas Electric ✓ Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family ✓Commercial <br /> Tyee of ro'ect: New Addition Remodel Repair ✓T.I. Sin S rinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 1 f� �'Ns 1-w�\ (c.� �.l�c��c., t doll (nsr n�-�►�5 n�.�� (� <br /> Z) 5c)7�k u.,) <br /> MECHANICAL. PERMIT APPLICATIONS PLUMBING PERMIT APPLICATION <br /> Type of Project: ZNevv_Addn _Alteration_Repair Type of Project: _Neva_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 /> z Gas piein2 Lavatory(wash basin) <br /> _ Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dr er I Clothes washer <br /> _ Ran a hood I Water heater <br /> .{ Exhaust fan Sink(service/bar/mop/2tc. <br /> Heat um Backflow ereventer <br /> Unit heater Urinal <br /> Boiler Drinkino Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting _ Roof drains <br /> (p Other t tvt S Medical Gas <br /> SPRINKLER / SUPPRESSIONS 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 I am au byth 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 /> Ow r/A 11.110 ed A nt Signature Date (Revised 9/2014) <br />