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t . <br /> • • <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# E M # <br /> 2� ► S w � �E �vs R�oo�Zo� -a 2 <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER a�G�.(d.N� ��...L Phone/E-mail <br /> Address 52p 29TN Ft�I� S , City/State/Zip ��.p�-� l,J�l1 9�10� <br /> APPLICANT:_Owner _Owner's Agent �Contractor _Contractor'S AgOflt _T0f78f1t(must provide a letter of conseM from the ownerto do work in the space) <br /> CONTRACTOR '(� ({qpD AOJD �(�CT' S�Q�IC$ �/uG State�ic.# /�TFIOOD�6�BOL City Bus. Lic.#03Q115 <br /> Address `roo rz���ve, S • �-,4�t,E W fac `�$1 OS Phone/Email�G��Z�' 'U��O <br /> • c, s ( ✓f"(�►oo . <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Ka-rA N'R SU5.1-E � �aY scr�Ne��y zo�•��.� •0�40 <br /> Phone/E-mail J'S �hQ�►�y�l�`�h�p�•GO� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � 129 O , o� <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Otner <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> T e of ro ect: New Addition Remodel Re air T.I. Si n S rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(additiona�space provided on the back): ��.� � Fi� Sa�/�e W\ {NT� <br /> Ktrc,rt6N /�dOD . -- 3 CsAu.oN �yezvcKevK Krrcr��N IGNIGNT � � W�'� <br /> C�ft�n�c,�l �,-Tc� {�,aN�FAc-TurLC—�.. �i uC.,3v0 —�s'l— S�-,�NDA2a5 • <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(#J of fixtures <br /> A/C—air handlin units Toilet <br /> Forced air s stems i Bathtub <br /> Gas i in Lavator (wash basin <br /> Water heater ' Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Clothes dr er Clothes washer <br /> Ran e hood 'i Water heater <br /> Exhaust fan Sink service/bar/mo /etc.) <br /> Heat um Backflow reventer(inside bld ) <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER / UPPRESSI TEM � 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 noL The granting of a permit does not presume to give authority to violale or cancel the provision of any other state or local law regulating construction <br /> That I a aulhorized by the owner of this pro perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> 4�2� • )� -� <br /> Ow erlAutho e n i ature Date (Revised4/2015);' /�� <br /> Z <br /> 1 <br /> '�...k.-, <br />