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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: o PROPERTY TAX# RMT# <br /> 6,30/ 3 414 A/ S�fr // I.2soyo300 oc:0o4:3 I VI I L0Dmo d2) <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER 7?.✓Gie,v'Wi rr(//7(Q5it .1 <br /> Phone/E-mail <br /> Address t ) E2,e f`�v frj f"W/-3'4,0'e ..-C33 J1- City/State/Zip , -e-cf` k_../ 1474 8/88 <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 l/h't- ' f n . fpK State Lic.# (/V/v '/ / 5'i'i City Bus.Lic.# 02704{, <br /> Address 17902. g - IV4 AML_G1,v*-k WA. 7800/ Phone/Email Zr* — 93,— ---G)/ <br /> TENANT BUSINESS NAME CONTACT FOR P <br /> /``///I7 h dvt:ii' 4.1-6. G/ JK 73r a vl f feaiiA 5L70'0 <br /> Phone/E-maill:)P74V GeAtiVerSditt firs f? .L' .7 <br /> ON <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4 / '5 o <br /> Existing Use of Building Cff"F'_/ilot.43e'J// ct�., HEAT SOURCE: <br /> Proposed Use of Building lM.CG / 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 /> r t/( CO /aeLc.G.'a 7 e_ ct5 Mor-40 Gtbrf/, C`/)eX Aef-401 s1 61e1c--4-.v49o' t <br /> 7'v/ks/ lyr5'7 moo( r-t 4-4wct/ aspi p-e–^ <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _NewAddn _Alteration_Repair Type of Project: _NewAddn AlterationRepair <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 /> 4/ 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 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 au by th ner 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 /> `j //U f ac,f 6. <br /> O r/A zed A nt Signature Date \ ) <br /> (Revised 9/201 <br />