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� . I�ERMIT APPLICATIO�I � <br /> BUILDING/MECHANICAL/PLUMBINGISIGN/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 /> SIT30�3 W• �RSIT�b �� �1/�R� (3i,� 40�'1 PROPERTYTAXfii PE i�# � <br /> LEGAL for new constructfon: Short Plat/subd(vfsion Lot No. (attach copy of long legal description) <br /> OWNER �}D� Phone/E-maU <br /> Address PD Q 0`�. �1 D7 M�S 0 H-t 3 ciri�steteizip S�-�, 9b i24- z?.0'� <br /> i <br /> APPLICANT;�+,Owner _Owners Agent _Contractor _Contractors Agent `T8118�t(muet proNde e letler otconeant from the owner to do work In the spece) <br /> CONTI�ACTOR D F State L(c.# �c9�M�-�-�b�i-1,GG Ci Bus.Lic.# <br /> Address Phone/Emaif <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �EPF Da.��t�R 47��-Z3Q-a�9� <br /> Phone/E-mail ,3EFPERY G. DRkYEK � gDEtNC+. COM <br /> BUILDING PERMIT APPLICATION coNTRAcr PRicE oF woRK �� ,_�,,T� <br /> Existing Use of Building I'�Fl� HEAT SOURCE: <br /> Proposed Use of 8u'ilding M�� Gas_ Electric other <br /> Buiiding type: _Single Family _Duplex Townhouse _Multi-Family �C Commercial <br /> T pe of project: _New _Addition Remodel Re air_T.I. • Sign S rinkler Demolition_Chan e of Use <br /> DESCRIPTION OF WORK(additlonal space provided on the back): � <br /> `�`� � L.l, • <br /> �h�a�.y r�9 �e��e5� �40r�� S�ou,� �t�o U�e.S-�1 Y�erv��� �n.teai oe� c�oo� � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJect: _New_Addn �Iteration_Repair Type of Project: _New_Addn _Alteration_Repatr <br /> Show Number(#)of f)xtures Show Number(#)of flxtures • • <br /> A/C—air handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas f in Lavato wash basin) <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ran e ' Dishwasher <br /> Clothes dryer Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.} <br /> Heat um Backflow reventer ' <br /> • Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ductin Roof drains <br /> Other Medicai Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> Number of Heads Other. <br /> . I hereby certity that I have read and examined thls application and know the same to be true and correct.AII provistons of taws and otdinances goveming this type ot work will be compifed <br /> with whether specKied herein or not,Tha granting of a permft does not presume to give authorKy to vlolaie or cancel the provision ot any other staie or local law regulating construction <br /> That I am authorized by the owner of thfs property to pertorm the work for which application Is made and 1 comply with the State Coniractors Law 18.27 RCW and 296.200A WAC� <br /> � �7 � <br /> � � �,�_.�...��. <br /> Owned or Agent Sign re Date (Revised 3/2013) <br />