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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: „win_ <br /> 1p4 po p ce PROPERTY TAX# IT r1 ^ _ ` <br /> LEGAL for new construction: Short Plat/subdivision At l ts Lot No.r29S (attach copy of long legal description) (/��(/n <br /> ilt m,1Oh <br /> OWNERS ®r\f.S Phone/E-mail 4125 (165 G.gC3C`.) <br /> Address i2o S� \I(? .e• n1t,Iry,C\0� 10(2 City/State/Zip �G�1Q( �� t�M/� q 2_o <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 r IJti,c2 01(041,14 PJ i11v1 ) State Lic.# (rte ANpLdii7L) City Bus.Lic.# s2Zq <br /> Address 6 ?2Z Aick:oo o sulk 0 a s Aohornishi, Phone/Email q'Zf 3g € 1009 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail 2.5 W 510 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK SLY- 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): C( L'Or ^ 0(00 <br /> MU (+1, (-4,3& lei 1 itiL, 5U 'II' - S Ltk <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 /> ,2L. 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 sp ified 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 au rized 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 /> r?j// j16 <br /> ner/Authorized Agent Si nature Date (Revised 9/2014) <br />