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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 /> smimS:G s cfv � t o L 1 3 ) '� 03 -02-9- <br /> LEGAL for new construction: Short Plat/subdivision (� Lot No. (attach copy of long legal description) <br /> OWNER —oc)K) V r Lyt� )--kA -� TI Phone/E-mail fl 353 --33 1 - 1 i LL <br /> Address r.Z0YE3 C.)1 a"c\A A vk . City/State/Zip Eli . te)- %C'),0i <br /> APPLICANT:_Owner _Owner's Agent X Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR pi cX,10ov4kcr Crfl-fotc±c f s1'._State Lic.# NW RNCL 9(3 n-I City Bus. Lic.# <br /> Address 3a3 0)Icrt'0 v . 6 L 5 L",.--k. k c�< 4)1'S <br /> J c3 } <br /> Phone/Email /�S y -t� �J .5 <br /> TENANT BUSINESS NAME JA42. St0-1;t,f) J WT ,`j'W:A CONTACT FOR PERMIT-1- t� �`) y vp, +q 9 <br /> Phone/E-mail q 5 --,s ';. - (1 9 e/ . <br /> .1' <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WOR ��1 OYjb <br /> Existing Use of Building )is 0-,Sit4A J✓1 HEAT SOURCE: <br /> Proposed Use of Building SC"YYt l 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 /> D SCRIPTION F WORK(additional space provided on the back): �j^ `� p ox-I-4 �� � <br /> e ( f�' 'ic�(� 5��\n� of. Setec\--cG'` 'C 1 <br /> r&v' Iii) ,I,.W;nt6o%,) --01,5h`r^ 5.ep,k ,k tit.r1-5 I tf:ImC1-0v) re,fiN (144, -Tris^). <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 /> NC-air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping I 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 /> j 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 this type of work will be comp: <br /> with whether specified herein. 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 /> Th2llaraattitiefized by the o . his 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 /> '----r—r-1 (?‘rine."\-(<1 C '."? .---i211( 3 321 -2 <br /> Owner/Authorized Agent Si ure Date / (Revised 9/2014) <br /> I I) <br />