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0 • <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 /> 22-04( 6ibso- ?- t -ve.r�tt-, WA 1'3203 11(x0(0 -- o -tf <br /> LEGAL for new construction: Short Plat/subdivision Lot No._ (attach copy of long legal description) <br /> OWNER -I--{ n <br /> {Leig �Obe.rf' F 4 Car I 12 42_V L4�ng Phone E-mail (y 2s*) 2 10 •- 5340 y <br /> Address 22-04 'i bScrl PI City/State/Zip e__V e.Je L-4't", WA '79 0.-0 <br /> APPLICANT: Owner Owner's Agent N Contractor Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR western TsTAar '1'\C_- State Lic.# weSTES-t$7?i) City Bus. Lic.# OG-//S <br /> pz Address Z-101-1 j H ot'Yte,Id 2t'QA J ltnojhtam VV, P. al- Phone/Email (3( o') r--14-ao - O ascii <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> n / ,, <br /> �� I f�-e - Gam- O .5,,,C_ (3(Gt'f2 <br /> Phone/E-mail (3(01) 171—/(0—Q$. (367 0)2254_elm <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK S_4"/, SI:?-7--- <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building ,S-FP---,S-FP--- 'f /2----D 6 p solQr V Gas Electric Other <br /> /� <br /> Building type: �, Single Family Duplex Townhouse Multi-Family Commercial <br /> _Ai-tera iov-- <br /> Type of project: _New Addition Remodel _Repair,4T.1._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): \ <br /> I0 Stc ro o-; p s 01 et PV cava p -1r I;1 c 1 ua.�, (32) (*e-t- € ro,/ <br /> 3 0 0 w ►&vD d v lc , Sola ra i '7 lvO 0 ±3-,i in ve_Kt--e-,- , axJ <br /> Yum:--,N acc,iz- (aL v--i nn Sy St-R t'Yt, <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of oject: _New_Addn _Alteration_Repair Type •f Project: _New Addn _Alteration Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> 3 A/C-air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater I Shower <br /> Gas fireplace ! .itchen sink&disposal <br /> s range Di • asher <br /> Clot s dryerf Clothe- asher <br /> Range od Water hea <br /> Exhaust fa Sink(service/:: mop/etc.) <br /> Heat pump Backflow prevente - side bldg) <br /> ( Unit heater Urinal <br /> Boiler 1Drinking Fountain <br /> Refrigeration I Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other ' Medical Gas <br /> SPRII1RtER RESSION 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 authori ..by the owner oft ' pr..erty 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 /> dr • 10/VI V <br /> Owner/Aut torized Agent Signature Date (Revised 4/2015) <br />