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5 <br /> • <br /> IRERMIT APPLICATII <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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX# P MIT# <br /> MOO -,/bo . SE . '£S 216D52ofc -zo<iezi 4612Q(o —O2 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNEISL kActie C. 14.0 • Phone/E-mail <br /> Address/646 S .MeststegAteitt t S -e.ei City/State/ZipSetA t eiajO, 9-is£09. <br /> CONTRACTOR 1= ..� A/1t"I rappl I f'un L&I Lic.# AA F T OC cq ZG, 1--VU <br /> Address WriSi-- 5 V 1le.c 117 e low i a_ 9-. Phone/Email <br /> TENANT h BUSINESS� NAME CONTACT FOR PERMIT,o6 e orazt (7i W � tlM <br /> ',Col, f A CAA WON t r , - 4 It . Phone/E-mail 204-46 "C1. 2,940 0 <br /> BUILDING PERMIT/► APPLI £ATION CONTRACT PRICE OF WORK(c)G/000 <br /> k� <br /> Existing Use of Building i co.CAI 6 Ce' (cLIA4:C)._ _ HEAT SOURCE: <br /> :Proposed Use of Building the 4;ca.,/ 6?11 Cc C GI-! 4 iG 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 /> Have you started working without a permit? YES NO <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 /> A/C—air handling units j Toilet <br /> Forced air systems Bathtub <br /> 1 Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range I 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 /> IBoiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other j 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 <br /> this type of work will be complied with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel <br /> the provision of any other state or local law regulating construction or the performance of construction.That I am authorized by the owner of this property <br /> to perform the work f. which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> - 6 . /. . 201Q- <br /> O ner/Authorize; Agen Signature Date (Revised 2/2011) .,., <br />