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i <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: alt r O.rh pi-ye yPROPERTY TAX# I PrMOT neo 3 <br /> LEGAL for new construction: Short Plat/subdivision PdP h 1� Lot No. alf(attach copy of long legal description) <br /> /� (�ti �rn <br /> OWNERS(;�yy PC({;(11` ++ tS (f� Phone/E-mail `E Lt 615-2, 'Zs n <br /> Address YID �vJ c e ++wy L I i, �- 10D City/State/Zip GV 2(P--'t \/.i r G /04 <br /> APPLICANT:_Owner _Owner's Agent (_Contractor ,,_t.I,�C_onttrractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR( ;L aced fI u,{ i IJP 03t. U�ll�% ldi,i State Lic.# / f')V/ j'J PL I-7L ity Bus.Lic.#c52$1- g <br /> Address i g22, t"7(tl,,wra (IQ S({( e V J SING vi( n/5 ifd4 0/1/4- Phone/Email L/l,5 :314 51 CC) <br /> TENANT B ESS NAME CONTACT FOR PERMIT <br /> . Phone/E-mail 425 6 5 . <br /> BUILDING PERMIT APPLICATION — CONTRACT PRICE OF WORK $1-4-)/7. CO <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._Sigp Sprinkler Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): ( ' C (. ©/ lJ Sci <br /> MO( <br /> 5-uppire_ss7c:use2r - <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 /> NC—air handling units Toilet <br /> • <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 Li 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 goveming this type of work will be comp) <br /> with whether specifiedtt erein or riot I he granting of a permitdoes norpresumeto give authority to violate or cancel-the provision of any-other state or local law regulating construction--- --That I am a thoriz •y 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 /> //56,44-S /2/`t/// <br /> Owner/Authorized Agent Signature Date (Revised 9/2014) <br />