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s . <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 I <br /> X10370tinAVEse — 01 <br /> LEGAL for new construction: Short Plat/subdivision p1 r 211--t/ifyhts Lot N0.1-144 (attach copy of long legal description) <br /> OWNER "`„�,' c. times <br /> �tk Y <br /> 1 ,f o �'y S Phone/E-mail U25 065 270C) <br /> il I <br /> Address ‘2Q v. -'JL' t 'ro.1t1V - <br /> L 14IOD City/State/Zip q .0 <br /> APPLICANT:_Owner _Owner's Agent Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTORIIDp(ad ppkinbi�i J 1-i-od) State Lic.# AriN?L'117L S City Bus.Lic.# <br /> Address i 22 Pj ck, d tbui,sulk hom I SYIf IAAPhone/Email s" 3g 5-100 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail 0,5 3 W 5 OO <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK yLO <br /> Existing Use of Building 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): et't0 0(0 022 <br /> linU 1 —F (jtXr fig -- <br /> t9 vr) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn Alteration_Repair Type of Project: _NewAddn _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 /> 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 /> 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 compl <br /> with whether spec, + rein 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 authy ed the owner of this 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 /> 074 eul <br /> Owner/Authorized Agent Signature Date (Revised 9/2014) <br />