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PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT"SERVICES <br /> 3200 Cedar St., Everett, WA 98201 4.25-257-8810 FAX 425-257-8857 www.evereftwa.org <br /> SITE ADDRESS: PROPERTYTAX# <br /> (0 )01 3 V`` LJ . bw I U <br /> LEGAL,for new construction: Short Plat/subdivislon Lot No. (attach copy of Ibng legal description) <br /> OWNER Va(APCP Phone/Email L Z5_37'I_ 31tY <br /> Address T 5 ul City/Statemp ;1 0. Q -2,0 <br /> APPLICANT:—Owner _Owner's Agent Contractor _Contractor's Agent _Tenant(must provide a letter of conseril from the myrier to Op Work In the space) <br /> CONTRACTOR E;YC- ,46I',r'—C --tA -5-fP-­i.-C­ 1�C,�-111`x- State L-ie, City Bus.L,io.# Pjo <br /> Address «v rc-Irl,(- �,1 V. t1,=�2 �,t f� q 9¢0( Phone/Email 4 2-S Z <br /> CONTACT FOR PERMIT <br /> j ,. <br /> J A�l�1��' Phone/E-mail <br /> BUILDING PERMIT,APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building f'/6 HEAP SOURCE: <br /> Proposed Use of Building No tg' fA36e Gas X Electric Other <br /> Building type: ^Single Family _.Duplex Townhouse _ Multi-Family _X Commercial <br /> Type of project: _New_Addition _Remodel _Repair_T.I._Sign Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space prov/ded on the back): <br /> . 12�12 Z. V ct✓tk t—l-v�l:vvLS _ t. ���lti�.� G r I�5�1�� t��c.(c�.•-�, <br /> MECHANICAL PERMIT APPLICATION I PLUMBING PERMIT APPLICATiON <br /> Type of Project: _New__,Addn Alteration K RepairType 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 Lavafory(wash basin). <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> 1 Clothes dryer Clothes washer <br /> Rande hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer-(inside bldg) <br /> Unit heater i1 DA 7 Urinal <br /> 1 Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I Ducting J Roof drains ' <br /> Other Medical Gas <br /> SPRINKLER / 9UP PRESS90N 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 provlslon of any other state or local law regulating construction <br /> That I arrn authorized by the owner of this property to perform the Work forwhich application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Omer/Authorize nfSi�nature Date (Revised 412015) <br />