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e <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: —1_6•A loth-h ce PROPERTY TAX# PM-409 31 <br /> LEGAL for new construction: Short Plat/subdivision RIN I k )Vtt Lot No.1 9. (attach copy of long legal description) <br /> OWNER 51U? - L. Homes Phone/E-mail 112,5 165 2.400 <br /> Address ‘'2O \)L.. -riyoxv.ia fitoo City/State/Zip C4(4.4+ * '20 <br /> APPLICANT:_Owner _Owner's Agent X Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 1 rhithre 2I&/fl bJ/'3 Ph.14110 9 State Lic.# i $"Lq l7L.5 City Bus.Lic.# <br /> Address f ) 2.2. P (CkfOr,r l Prtiti.jt,1 ' 0: S jno y tom ishr WA. Phone/Email Lac 3g 5100 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT p� <br /> Phone/E-mail L 2,6 -N4 W 5 )0 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK G7 ! <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 lDemolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): C ) 'LeOC -0(p Z <br /> _ (JO& ---(0)2___ 57a reLL-4S/ CY] <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 comps <br /> with whether specified 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%zed b the owner of this property 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 /> I Z7/ /fio <br /> Owner/Authorized Agent Sign ure Date (Revised 9/2014) = <br />