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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES 0 t 5'2-- n' <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org L <br /> SITE ADDRESS: ./.44 PROPERTY TAX# P R T .. <br /> 27111 Zoot- oda?,z0000 130 ' <br /> LEGAL for new construction: Short Plat/subdivision ute 1 <br /> /"- P Lot No.t (attach(a copy of long legal description) <br /> OWNER � /t Pe-X/1'4'0 Phone/E-mail �i Ji'C/ 4 U c •{441.00 .CJQ16,1/4 <br /> Address V I `ZIG h.. se, City/State/Zip r...1/20-ei(1 11.1* <br /> APPLICANT: / Owner _Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR State Lic.# City Bus.Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CO TACT FOR PERMIT.-.. <br /> 12k4 M ' L.% It c-W pw)Q ri/ctAla- <br /> Phone/E-mail1, , <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4).--G o000073'[y <br /> Existing Use of Building 2C / 13 .EAT SOURCE: <br /> Proposed Use of Buildingl( 1CAt1 - Electric Other <br /> Building typT 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): <br /> CLY\nv ia,r�e i Vt°rb A -H { utraomS <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _Ne Ad ``Alteration_Repair Type of Project: _New • Add Alteration_Repair <br /> Show Number(#)of fixtures Show Num.er(#)of fixtures <br /> 1 ," NC—air handling units 1 Toilet <br /> Forced air systems Bathtub <br /> Gas piping -% Lavatory(wash basin) <br /> Water heater l Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> I Clothes dryer i Clothes washer <br /> Range hood Water heater <br /> 2. 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 /> 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 specifie.herein or n..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. .•/ the. is property to perform the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. <br /> IOWA <br /> , r/Allegslta....., / -- V 1:7-- <br /> 0 e/- -hor -d Agent Signature 4 .X--ate (Revised 4/2015) <br />