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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# PERMIT# <br /> 30 I ( u1b1 A vt c0d `t 1A1 4110 00100 9Nli5ba -OD( <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER S+04\kA KorActNit oV Phone/E-mail '760 • Co37.44I15 s+0/r11-3(, o�t�oo•GO.M <br /> Address A30) Co t n Ave #S E 1 City/State/Zip aver 4-4 1....)A- elb 20 1zo <br /> t <br /> APPLICANT:_Owner _Owner's Agent _Contractor h!Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR bjJ \ f.( State Lic.# City Bus.Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 9-0%VAN. iv'"Ntt"tk k CY <br /> Phone/E-mail <br /> /� �Jg <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 70L/� <br /> Existing Use of Building 1"Q-S -Dre a fes tp-i. I v' . 01k22-j 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 /> bce c gcc 1.4-5 Fa 9 <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 /> I Clothes dryer Clothes washer <br /> Range hood Water heater <br /> /61 Of '%_ Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal • <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain '`A► <br /> Woodstove Grease trap r <br />^ � ) Ducting Roof drains <br /> ` Other Medical Gas <br /> (a SPRINKLER /SUPPRESSION SYSTEM Other: <br /> liktt <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 constrgalor) <br /> That I am authorized by the er 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 /> Owner/ orized Agent Signature / Date (Revised 9/2014) <br />