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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: t L z4 4 Z" S�' PROPERTY <br /> Z ro c l?''©°3 0q6 00 UN) <br /> LEGAL for new construction: Short Plat/subdivision . Lot No. (attach copy of long legal description) <br /> OWNERJzr,LQ Art,erJ [_ (i�� Phone/E-mail �y[� <br /> Address 1 Q( %0-111. ,CjL"'� City/State/Zip E.iVr f.'' �tzQ 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)c <br /> CONTRACTOR 6-01,41-4r1" /" � A'rliGQ( State Lic.#(4 friFr�/�►XO/544 ity Bus.Lic.#6774172 <br /> Address -320z -�- n�� Phone/Email q Z 5 s/ g29O <br /> � s <br /> TENANT B SINESS NAME CONTACT FOR PERMIT <br /> .Tesse G41"GlC ) <br /> 0 Phone/E-mail'IL S zc/q'ggv Jess e(q)Goi-,6c4,, erJ c <br /> G <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK (3,..7 a C <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric./ Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family L./Commercial <br /> Type of project: _New Addition Remodel Repair T.I._Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTIONIOF WORK(additional space provided on the back): i (-5•4 n C Okr r <br /> IRS4-dcc e..sic°4'.s .�a«, aad G�r.�c.•�r v e /'CsSo(S <br /> -ror t/engn . a!o4-0.. f'sr 5 1:a1-45Cc"1"pfQSSoc- <br /> nix.k, <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 /> ' NC-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 /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood. Water heater <br /> ( Exhaust fan . Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove •• ' Grease trap <br /> 1 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 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 owner of this property to perform the work fopr which apis made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> • <br /> Authorized Agent Signature Date (Revised 9/2014) <br />