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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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM G 13-13 <br /> SITE ADDRESS: 2 0 h 3 "A 1 e C si�v IPR0PET # <br /> / 714 19 ,14) I P Iivti 3 —0„ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) f <br /> OWNER TIO9 I I/k� Phone/E-mail <br /> Address '306 W. (OLS I {2b City/State/Zip 6Are rc `3jAift ' 8 ZD L( <br /> CONTRACTOR j-f'ria vSb w L&I Lic.# He(2-M1t CL.i O S <br /> Address 127,f ud,)q-( N, �[ w'f) ji4L e U O 2. Phone/Email 2,44, - 5 S 1-10b <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �j►-St�r� F-0,uSla) cf <br /> BOIYLJ 110 -53 Phone/E-mail 2-5'27-1b - S ti" [ 2- <br /> BUILDING <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4 Is, O o a <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building _ 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 /> Iv Skiit DVIU �1� trL*i— SoU(t- k t 1Vinip Gtkta? #tSS <br /> hekt.c/kaVLrc_01 l pl 2 / <br /> Have you started working without a permit? _YES ( NO <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 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 <br /> this type of work will be complied with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel <br /> the provision of any other state or local law regulating construction or the performance of construction.That I am authorized by the owner of this property <br /> to perform the wo . or which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> -A14- ; . <br /> 0 er/Authoriz- gent Signature Date (Revised 2/2011) <br />