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x.- f <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: PROPERTY TAX# # ^_� <br /> I .2-.3 132r pEi to �'��/tr/j�•J� <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <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 Crov in PI ye ¶ O-1echan C State Lic.# OU/AJF LhLiaL, City Bus.Lic.# 0.jigg7 <br /> Address leo Frox 12113 Phone/Email 1/25•1/8)•7d40 q <br /> TENANT BUSINESS NAME CONTACT FOR PEWIT <br /> /cn'i-Hrn 1i#-r7eSS Cr ist>� 9/ nd <br /> .4. <br /> Phone/E-mail 4/25.2/81.7(p(pq/J55KAer_rotw.1 . Coy, <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 700. I <br /> Existing Use of Building cZeAna.9.. HEAT SOURCE: <br /> • <br /> Proposed Use of Building _e <br /> � � Gas__ Electric Other <br /> • <br /> Building type: Single Family _Duplex_Townhouse Multi Family Commercial <br /> Type of project: _New _Addition —Remodel _Repair T.I.X Sign lSprinklerVDemolition Change of Use <br /> DESORIPTION OF WORK(additional space provided on the back): <br /> Add. CEJ { r ?dart" sprinkler' heads <br /> Aeta (3) vprlohl- sprviik er hec r <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: -__NewAddn _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 /> Forced air systems I Bathtub <br /> Gas piping - <br /> Gas <br /> Watheater I Lavatory(wash basin) <br /> I Shower <br /> Gas fireplace <br /> Kitchen sink&disposal <br /> Gas range <br /> Dishwasher <br /> Clothes dryer <br /> Clothes washer <br /> Range hoodry <br /> Water heater <br /> Exhaust fan I Sink(service/bar/mop/etc.) <br /> Heat pump I Backflow preventer(inside bldg) <br /> Unit heater I Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration - <br /> Woodstove Floor drain <br /> Grease trap <br /> I <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM ( Other: <br /> I Number of Heads <br /> 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- authorized by 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 /> i <br /> AN /WI / � i/L.%/ ` <br /> •wn> ,ut orize•Agent gnature Date <br /> (Revised 4/2015) <br />