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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 /> SITEA ^D S 3 Vie ST PROPERTY TAX#aqrPrea✓005 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER 4ILLS Tie EET f A)1) Phone/E-mail I25" 2 s"5 ity4'5— <br /> Address P 0, 60 x 5- c9 City/State/Zip E Ll fiiT/ h �p p <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 D£RA)E at*toirc i)1 SA e_ State Lic.# Gmbui: aC LC.I K(- City Bus. Lic.# <br /> Address 4O a7 rO WI-Ex_ Ann__ f) um 9.9 O Phone/Email 42s, ..3q.3--g-/2 2- <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> SOup 1J '�LL ,p L / c� . 1 �t i9A)E.. 4 Lt)ro.e� <br /> 4 /�EFEe./�ot'ze !dAJ Phone/E-mail 42c-3q -g/22 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORKEa,_,fQ06. av <br /> Existing Use of Building i A 14-/C HEAT SOURCE: <br /> Proposed Use of Building = E._ Gas_ Electric_ Other_ <br /> Building type: _Single Family _Duplex_Townhouse Multi-Family X Commercial <br /> Type of project: New _Addition _Remodel Repair X T.I._Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> $4,o D I Ft( ,E xr6%/, - SP .g. ,c"u'L. e£z.oc# sex) lsF .Ic.I57-,A.) 7--NA.Air <br /> AS D,E&.. Pe--4A)r DzISe, 5/444 Fae. iv€.60 7-1N;0/N 7-MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New, Addn XAlteration_Repair Type o 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 /> 1 • hes dryer j Clothes washer <br /> Ran.- ood -ter heater <br /> / Exhaust 1 Sin ervice/bar/mop/etc.) <br /> Heat pump. ; :-.. '.-.. -•- er <br /> Unit heater. i Urinal <br /> 1 Boiler Drinking Fount-' <br /> Refrigeration 1 Floor drain <br /> Woodstove Grease trap <br /> lunaiP7 Ducting 1 Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> ASAnErDEl7 Number of Heads J Other: <br /> — <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 specked 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 construct'' <br /> That I am authorized by th owner <br /> $'2—13 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 /> � <br /> Owner zed Agent Signatur Date (Revised 3/2013) <br />