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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: 2 410.11t <br /> �� p p PROPERTY TAX# REIjIVII� ' r`� <br /> LEGAL for new construction: Short Plla�t/�subdivision K1ptn V CIL S Lot No.M9Z. (attach copy of long legal description) <br /> l� <br /> OWNERSeGLiikrz Horf\e Phone/E-mail 125 I6- L.pop <br /> Address \'2 0 w) \le �( 1�1Via0�I"1 i City/State/Zip C (-2,-H- q?20"I' <br /> APPLICANT:_Owner _Owner's Agent 1 !Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR /r' p1(y��i,7)�,bl/ r J J41 JV'9 State Lic.# A p'1.. (3L.5 City Bus.Lic.# <br /> Address k22. P- Gk.(i2d�r4Q ,sulk 0 o Snokwniish,i,vlA- Phone/Email -/IS 341 V 5i 00 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail 11/2 .54 W 5 20 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 0 <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_S rinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): (, ` ( , <br /> 0(0 (5SLO <br /> Mit I—fi — (-Jo& L.Ljsi, <br /> -re/A/L. 5at9,11 <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 /> 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 /> az. I 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 specifi 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 construction <br /> That I am autho' d by the owner of this pro rty 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/Authorized Agent Signatu Da e (Revised 9/2014) <br /> /L <br />