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• <br /> iERMIT APPLIC,i.Tie <br /> • <br /> BUILDING/MECHANICAL/PLUMBING/SION/SPRINKLER/DEMOLI-ION <br /> ' CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wbUrfry . <br /> SITE ADDRESS: s� II PROPERTY TAX# P RMIT# <br /> ZO ( 00370-0600410 Ci W ()!O f)O <br /> LEGAL for new construction: Short Plat/subdivision Pk11 6•ri / G j Lot No. I- (attach copy of brig legal description) <br /> OWNER O( (ik1.. 6 0( 4 Phone/E-mail . <br /> Address Zdt( 666r \ • -i City/State/Zip <br /> APPLICANT: Owner t owner's Agent _Contractor _Contrractor's Agent Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> �65 '-7 112 m_.[ 1 State Lic.# City Bus. Lic.# • <br /> CONTRACTOR �- /"®_�I <br /> Address • Phone/Email <br /> TENANTBDSINESS NAME CONTACT FQR PERMIT <br /> ` .1Z(41/ 'r' 1AlLC-0 . <br /> Phone/E-mail j lD I C- -- , <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building F-.F HEAT SOURCE; <br /> Proposed Use of Building P _ - 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): <br /> CcJt'Et .3.43¢ • F 11(2-046- • 1t) 13aver 'L L 2 2# ( - <br /> 1300'47 OPO 410g/46 VcritA W t-t w 67-4- F Dlsc 6 'art Q <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Adds _Alteration_Repair Type of Project: New_Addn Alteration__Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC–air handling units 6 Toilet <br /> Forced air systems I Bathtub <br /> Gas piping. Lavatory(wash basin). <br /> I Water heater I Shower <br /> • 1 Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> 1 Clothes dryer Clothes washer <br /> I Range hoodWater heater <br /> 2.. !I Exhaust fan I Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> I Boiler Drinking.Fountain <br /> I Refrigeration Floor drain _ <br /> Woodstove I Grease trap <br /> I Ducting I Roof drains . <br /> . I 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 wit be complied <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 authorized by the oi'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 /> 41.111111 — Al. —...01111111k atIFAIW. - <br /> Own:/Authoriz d .gent Signature <br /> i�ate 1( (Revised 4/2015) <br />