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R <br /> 4 <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„,4.1.0 ^ YW `,f- ce. jPROPERTYTAX# QtjFtll <br /> - Pj#2 — <br /> LEGAL for new construction: Short Plat/subdivision PkVis1 ��"J <br /> " S Lot No.1-pp (attach copy of long legal description) <br /> OWNER S(°h PC((;(el C,! t S Phone/E-mail Lt 615'` Z.) ' 4� <br /> Address rip c c.2�1,ejt.(-T \A J 6 \>� cq- IOD e-City/State/Zip )Q ,e- '1 \A Pte qsi?21)4 _ <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 isqra ,inced ottr1 h 3 i3 V m ill:,! State Lic.# /MANI PL i—]�.ity Bus.Lic.# (-- -,7 c_k . <br /> /� is/, pro,/ <br /> i , ,((�� y� .J i^ I, <br /> Addressip22 eidkra > s St(k� 0t SINGY1(1{ (;lfd` (!✓YT Phone/Email q`IS ,J`I 5100 <br /> TENANT B ESS NAME CONTACT FOR PERMIT <br /> • <br /> Phone/E-mail Li- 3"L 5 ISD . <br /> BUILDING PERMIT APPLICATION`"-- CONTRACT PRICE OF WORK $14117. 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): \,v/_ �t(10 I <br /> MU(11 '"-- use .rire, 5appre,,ss7 <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 /> I L 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—tether specifiedrerein or not:i he granting ora permit-does notpresume to give authority toviolateor cancel-the-provision-of any other state-or local law regulating construction--- <br /> That I a uth ed 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 /> Owner/Authorized Agent Sign ture Date (Revised 9/2014) <br />