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i • <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 ADJ;2E S: ©{j PROPERTY TAX# P RMIT# <br /> . DZ 3 W CASINO u Evgaf 6, �i <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER �b���l�rttr7 Phone/E-mail �w ' ` /1 �7 <br /> Address P6 Mi 3-107 N 15 J R—VS City/State/Zip S'&KnLr., WA -1 b IZ-t-220-7 <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.# b+NG City Bus. Lic.# 61 j 70S <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Dull ga5-235-0111 S <br /> Phone/E-mail "g 9A� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORKr ,2,6,, 2G ,.. <br /> Existing Use of Building MSG HEAT SOURCE: <br /> Proposed Use of Building M F& Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family Commercial <br /> Type of project: _New _Addition Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> gUiLDfNG/h�pl�) 11oN /' v,,-v�VT �YS�ir�i� Ui'la ,�S`/zerrl�'i� exlS�/N6 ,� 2�� c— <br /> UJr— Cc �/htJrl){LiG' /1T177vA)11C- <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 <br /> Unit heater Urinal <br /> Boiler j 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 II 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 /> i1iJ l"29t <br /> - <br /> Owne(AuthoA24d Agentnature Date (Revised 3/2013) <br />