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. 111ERMIT APPLICATIOt <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: PROPERTY TAX It PERMIT UU <br /> Z t 2 `�s - �_ SG &ht-c �-3Q 3700 2r2_s2�� &1 D .' <br /> LEGAL for nk�iew construction: Short Plat/subdivisionklier { ZhalaS *2. Lot No.23 (attach copy of long legal description) <br /> OWNER AA41-1 Ly6.) Low' . Phone/E-mail <br /> Address ?j().___ 7s-v-, ,due 3Q. City/State/Zip 2v€.4-Ng_ril.) ..).A.-- -( z-oar <br /> APPLICANT: Owner _Owner's Agent X Contractor ,Contractor's Agent —Tenant(must provide a letter of consent from� the <br /> owner to dp work in the space) <br /> CONTRACTOR VARA. tSE CGns`1�w atm vLState Lic.#p R,4 Dc j C') City Sus. Lic.#O5337, • <br /> 314,-144- I t 1 I <br /> Address 147S-I NI I�eLs 5[ 3 ( N(ihri q -7 Phone/Email t401-1-Ii2vICr fo 6 nst,. <br /> TENANT BUSINESS NAME CO TACT FOR PEgI <br /> ‘-1 -Li i- Ec.R. 20G- 3 o v-G$(co <br /> Phone/E-mail 40(1169v t f%tt 0(J '-(s k). C-G}.-� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK t 7%, q 9) <br /> Existing Use of Building S�R • HEAT SOURCE: <br /> Proposed Use of Building S t- R Gas Electric Other_ . <br /> Building type: ,4 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): P <br /> Reek--SCE 'Et'Ze Pa,rar1 a cl �-,� <br /> e . s <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: , New_Addn Alteration Repair Type of Project:A,,New Addn Alteration,;_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC-air handling units I Z. Toilet <br /> Forced air systems 1 Bathtub <br /> Gas piping 2. Lavatory(wash basin). <br /> jA Water heater = I Shower <br /> I Gas fireplace . ! Kitchen sink&disposal <br /> Gas range g Dishwasher <br /> /` Clothes dryer / Clothes washer <br /> I / Range hood i Water heater <br /> 3 Exhaust fan Sink(service/bar/mop/etc.) . <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> 1 Woodstove Grease trap <br /> I Ducting Roof drains <br /> Other I Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM t 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 complied <br /> with whether a.ecified 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.d r. ed by the.wner 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 /> %wner/Authoriz=ttgent Signat re Date (Revised 4/2 <br />