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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: is 53rd TO ,co--606-OIo-. C15(,'_oo3 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER ParKClie.►.J Seco�0.�j, Phone/E-mail <br /> Address /7 sq j4 az. City/State/Zip nom- L 9 (33 <br /> APPLICANT:_Owner Owner's Agent Contractor . ,_Contractor's Agent _Tenant(mustprovide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 1Y) AO Con Sk O 4-i State Lic.# m pi (J 'eoL -Q?l3 City Bus.Lic.-#0514506, <br /> Address aa003,.. 38141 f Q- €A0- C � Phone/Email v fA �n Mg./ ,- , <br /> TENANT BUSINESS NAME CONT CT FOR PERMIT C� <br /> 4<t2A)."` 19 <br /> Phone/E-mail Y-A0 Go I <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK (ooO <br /> Existing Use of Building HEAT SOURCE: _ <br /> Proposed Use of Building j eys)e• QQ9A . Gas!t5( Electric_ Other <br /> Building type: x Single Family DuplexTownhouse _Multi-Family Commercial <br /> Type of project: _New _Addition V Remodel _Repair_T.I. Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additionsl space provided on the back): • o d I bei, COOS t•W:fle- cfc(ZS <br /> folk t sf�,, r �-/- i( r QCces 6 bl r <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New Addn ZAlteration_Repair Type of Project: _New_Addn j&Alteration Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <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 /> 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 prevent ter(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Founta <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 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 for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> tifOr <br /> Owner/Authorized Ag: t Sign Da Dae (Revised 4/20-0) <br />