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All <br /> . 'ERMIT APPLICATI <br /> BUILDING/MECHANICAL/PLUIVMBING/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# P J MIT# <br /> q n 80. S4 iA) St".- tcc) ---6 ) <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> • <br /> OWNER Cove_ b.,,,,,,,„( LGL Phone/E-mail Sly- ,/7 /,-/r/,pG . . <br /> Address /94/0 4/0 /24/4( //mac ,,4: /4/0/ <br /> 4: /4/d/ City/State/Zip 13 e.(/G✓t.� l.-�6. /0��� <br /> APPLICANT: Owner Owner's Agent •Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CAI,L P/144„ L, _ State Lic.#C.ZryPI Y*4 KS City Bus. Lic.#O 2I • <br /> Address4132 V7 AOC. E 1/A-ysv!4 94tZ7/ Phone/Email g6,0_v:5-4/oyg'/ <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 5x.. pa.Pws-t,:k. 360 /s ps, <br /> 7?e- to / that Phone/E-mail J Po`./9e4'01-/A.eG O/w/ .'".2. •Drs . <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORKf,o 0 <br /> Existing Use of Building HEAT SOURCE: <br /> • <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): <br /> '1(4-...)-'•vs, 4,r -/- WLt./{•- /t/1--p r vv r-1r---1-- <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 /> • <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 /> • <br /> Gas range / Dishwasher <br /> Clothes dryer /.6” Clothes washer <br /> I Range hood 2_, Water heater <br /> Exhaust fan . ' I Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> . <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 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 authoriz-, ry the o,•; of •is 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 /> -16-Owner horized,Agent Signature Date (Revised 4/2015) <br />