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oqet, IA* <br /> N1 <br /> Vec <br /> IkRMIT APPLICATIO Coo" <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# PERMIT# <br /> 65o1 36' min w. za bqosoo 'ooBOo f IWS-06( <br /> LEGAL for new construction: Short Plat/subdivision Lot No. 2- (attach copy of long legal description) <br /> OWNER PAA/A1)eJeloplw4A Phone/E-mail �t <br /> Address 63yo For} eAk aNlr'� Sv:Fe. Ty City/State/Zip Se..-'tKL fg/g� <br /> APPLICANT:_Owner Owner's Agent X Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR Pkf IOT F1( PLa7ECTieJ L&I Lic.# PATQ1cq COE Bus. Lic.# 0,2_40y <br /> Address 2'Zo - ?v'M Avg t v—or le42‘f Phone/Email Z53-/24-Z29c) <br /> TENANT BUSINESS NAME / CONTACT FOR PERMIT <br /> Sosvio 4a k;otter.c'e-.Cow- <br /> f Q� f}J_O/A/AS Phone/E-mail iL au". 2C1-,05- ?Ye/ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORKKS oao" <br /> Existing Use of Building 13__ __ HEAT SOURCE: <br /> Proposed Use of Building `grs'—Z Gas Electric 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 /> /v 9Fa N he,a S f r;AV\v 1nc,.�s i i. :o� C\ c;e, s�:�� Wmvc t„,,S <br /> Sre.A,C\s.r cy/ler' <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 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 /> 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 complied <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 autho - by th j 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 /> • ner/Aut ' ed Agent Signature Date (Revised 6/2012) <br />