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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: L - ZVA/1 PcV c PROPERTY TAX# \EL \ _1oL1—SO <br /> LEGAL for new construction: Short Plat/subdivision r I I .L \kUVi VI,tS Lot No.'I (attach copy of long legal description) <br /> OWNER 9�{� WC(h(, t c fes, Phone/E-mail X 25 615-2, <br /> Address D �4� ��1 I��,{+\A \c U( \ q-k(I or) City/State/Zip e.V e(-e,- /�t \Arycr "l <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 /> CONTRACTOR `'I'f',oA&ed p' , h)V3i1., \i\.4-12,„rU State Lic.# /4NANI PIS -71-Ccity Bus.Lic.# <br /> Address922 f'7jGi°. ira S`t.tt fr 0, Smil /5ht + 1Ij Phone/Email 1.415 3L R 5100 <br /> TENANT B ESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail 425 t..J Lig 5 IO <br /> BUILDING PERMIT APPLICATION` CONTRACT PRICE OF WORK $410.00 <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): /� L/ o f —0 2J1 <br /> v la l0 <br /> MOV-i u_Se 5appire.SS/c7y) <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 /> 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 /> withwhether specified herein of not:I he granting of a pemlR-does not-presumeto give-authorityto-violate-or cancel the provision of anyother-state or-local-law regulating-construction----------- <br /> That I am auth• zed by the owner of this property to perform the work for whichapplicationis made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/Authorized Agent Signet a Date (Revised 9/2014) <br />