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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#P P MIT# <br /> (MO 2� — tIZ , T 0t29iou, - 5- oa ) -ODDS .e16,07.-/)7- 063 <br /> LEGAL for new construction: Short Plat/subdivision ��11 Lot No. (attach copy of long legal description) <br /> OWNER NMCA°L a T''tf'�G4ti1g, 4' 1-V•��f Phone/E-mail <br /> Address 2/0 O ej , 0 ICLAS SI, S 1 T( City/State/Zip Si *c icE f w /- -! 5 1 0 9 <br /> APPLICANT:_Owner XOwners Agent _Contractor _Contractor's Agent _Tenant(must provide a letter ofconsentfrom the owner to do work in thec01.- <br /> Address <br /> space) <br /> CONTRACTOR (i L i W to S l�CT1 OA) <br /> State Lic.#60-Co t O 1 v d "I City Bus.Lic.# b 2 (7 V t. <br /> Address t 0 0 - ‘ , p` 1- ( SE., J . 1JFu><c/Y (L Phone/Email Zo(0 24 2.0 22_ <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT c GhF <br /> C.-4i f 1 Uri(��.1 fit- td$w . 1`-1 <br /> CA. Phone/E-mail42-5 ZI% 076(5 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK± e�U 0 0 <br /> Existing Use of Building -F"( , 13.. HEAT SOURCE: <br /> Proposed Use of Building 4-.A'tit F:- Gas_ Electric_ Other <br /> Building type: _Single Family _Duplex Townhouse _Multi-Family X Commercial <br /> Type of project: _New _Addition _Remodel Repair 7XT.I._Sign_Sprinkler Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): N�""' i t 7 (JfCL•Vi0(gG Oen•c ) <br /> t - 1 o T t 8'T' *.).4-' 3 * pot- .-t A--L. A-c7r. C c. t Lt N G/ <br /> -11(„15,S. 4, NI ___w. wA____.z.l.._0,___I, ip - _,L.L._ "") p - „,. p 1..1 t--41 <br /> MECHA AL 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 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(inside bldg) <br /> Unit heater Urinal <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 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 constructi <br /> That I am authorized by the owrter of this prope to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A W <br /> Owner/Authorized Agent gnature Date (Revised 4/201 <br />