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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: �� PROPERTY TAX# <br /> ?/5 l©®t �eg• hR 14-05 <br /> *05—DO[ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description)) <br /> OWNER aptvikiwi to A 11 tt' CO, Phone/E-mail '-(25^)41?-3 f 5" 5c017-3-Q CASCA.i. c>7fc Ftp, aj 1'k <br /> Address pQ,tyQx 5 z City/State/Zip u614 a,_'rt '4 IN ?S206 <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 —['li-1�� 7 ,ViLState Lic.# City Bus. Lic.# <br /> Address 7 1J LLA Phone/Email - qQ ? 3O <br /> TENANT BUSINESS NAME SUQ� Ltc, CONTACT FOR PERMIT MAW.< <br /> �OCstl�9�6 VAtstsi l a\neVskpiA\ Phone/E-mail itMv�FvlA`?ksiv,F1l:rk , <br /> �e`14,0.s *,CO U <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �,60(� <br /> Existing Use of Building t0f4-t26 i/O(,f.SE. HEAT SOURCE: <br /> Proposed Use of Building (,,t3-0( f -rEOU S GasElectric Other_ <br /> Building type: _Single Family _Duplex Townhouse _Multi-Family X 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 /> PAdic <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 J Urinal <br /> Boiler I Drinking Fountain <br /> Refrigeration Floor drain • <br /> Woodstove J Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER /SUPPRESSION SYSTEM I 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_lied-= <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 oft. . _ _•erty to perform the work for which application Is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC.7 t <br /> l {l <br /> Own / uth e= g> Signature Date (Revised 3/2013) <br />