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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: ' 20" w " PROPERTY TAX# PB�Rp1I1T t n /1 _ 9 <br /> LEGAL for new construction: Short Plat/subdivision Pdo ne f 1 Cog l S Lot No.S1 (attach copy of long legal Cde`scriptionn)) �J <br /> OWNER Se Ck% Homes Phone/E-mail q'25 15-i2) <br /> Address ‘''�QyJ \)LQ -watk\AA $4IOIV� City/State/Zip J2�t �-, t, CI 2,0 <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 /> CONTRACTOR r aij2et pit/Mb/rigPi/IA-hi/19State Lic.# tJl AlpopL p. 913 LS City Bus.Lic.# <br /> /� <br /> Address Z �lcahr,.Q /3ut,�.511iik0: Sllvi�aniishr1A/A- Phone/Email �f'ZS ,fig V 5-100 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail `"9 26 5100 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <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): (► 1 t_0 Co <br /> T(L) <br /> (11(111+.1 Ck <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICA ION <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 con-ect.All provisions of laws and ordinances governing this type of work will be comp) <br /> with whether s, cified 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 a orized by the owner of this ropeity 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 /> (-1,//c/76 <br /> Owner/Authorized Agent Signat re Date (Revised 9/2014) <br />