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+ - r <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 loaf 'n p`/p c— PROPERTY TAX# PERII�IT'#�� _co Li <br /> LEGAL for new construction: Short Plat/subdivision Fkl YlL►u RelO '`t Lot No. (attach copy of long legal description) <br /> OWNERS ccu ti C-- HOMES Phone/E-mail 425 %6-5 2400 <br /> Address ‘'2Q �r) vL "watkvA .0100 City/State/Zip 01 ( ,f4 A q '2,D <br /> APPLICANT:_Owner _Owner's Agent i>(Contractors_Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> u?f <br /> CONTRACTOR QG pIu nbi )g''Is phx-f State Lic.#.AI .pLW17L.3 City Bus.Lic. <br /> Address ! k2Z Ai ck K}rd Ake,st /k ID, S leo hum j jh,.1,04Phone/Email laS 3g V i Do . <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail L — h�OO <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK. g. <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): /�^t vo(' — 05( <br /> (nu 411 (j(5,& / 57areLL-L-ys/ <br /> L4(t <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 comp) <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 auth ' ed bed b'`the owner of this property 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*1--/ ; / <br /> Owner/Authorized Agent Signdfure Date (Revised 9/2014) <br />