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RMIT 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: / 3� 1,04 PROPERTY TAX# P,€RMIT# <br /> G <br /> 7V1 r2�- A/4 r'7F "uU (J t 5 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (atttaach copy of long legal description) <br /> OWNER(�XIV <br /> iR f tt <br /> ,.iil p. Phone/E-mail 3J 0 ev OJ ) <br /> Address City/State/Zip <br /> APPLICANT:_Owner _Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In /thespace) <br /> CONTRACTOR G 4. /at* it rd,v'-�la+�i,.Gt^-t- State Lie.#1/"C•66/4174/ City Bus. Lie.#Of /ygg <br /> • <br /> Address • Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT Jr�- i4o,4.4'.0 d',s'f/' ''fi ''- <br /> JA.-t710 Pci,6-5. sf /,J..r .aa <br /> Phone/E-mail /Z c-36/.5--.3 to ' <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 61401000 <br /> Existing Use of Building Yrk_ HEAT SO RCE: <br /> PBuilding <br /> Proposed Use of 5't Z. Gas-_ Electric Other <br /> Building type: Single Family _Duplex Townhouse _Multi-Family Commercial <br /> Type of project: —New _Addition _Remodel )4 Repair_T.I.—Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPT • <br /> ION OF W°�K(addition I space provided or bacciic) �� (14 <br /> u,11 <br /> toll <br /> %.,o�✓�j9/ 4 #J{Sei - bdi-dL,7,, sti Ufa , -tzgc WW 7 - <br /> MECHANICAL PERMIT� APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New.4 ddn ✓Alteration_Repair Type of Project: _New 'VAddn Alteration_-Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC-air handling units 2i Toilet <br /> Forced air systems . Bathtub <br /> Gas piping , _ Lavatory(wash basin). <br /> Water heater Shower • <br /> - Gas fireplace Kitchen sink&disposal <br /> Gas rangeDishwasher <br /> Clothes dryer Clothes washer <br /> ' I Range hood Water heater <br /> - Exhaust fan I Sink(service/bar/mop/etc.) <br /> • Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration . Floor drain . <br /> Woodstove Grease trap <br /> Ducting I Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: - <br /> I hereby certify .- a'-read d 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 complied <br /> with whet - specified•e- 'r not.The granti I• - V.•emit does not presume to give authority toviolate or cancel the provision of any other state or local law regulating construction <br /> .. .. I- authorizedwne - •rope• o perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> 0 --r/A - orized Agent Signature Date (Revised 4/201 ) <br /> V'� <br />