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• • <br /> 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 AD) E S:5 .1) PROPERTY TAX# PERMIT,# <br /> •DL 3 �I ASING, 74) NEW- 51.16' 3 ic)0(o 60(c) <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER BOCA11 U �t q Z Phone/E-mail <br /> Address Pd Mi. 3-10-1 11M 1 S U 6't" J City/State/Zip S-WILL, WA 'IZI--220 7 <br /> APPLICANT: )1; 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 J.—/,J F/4091-) State Lic.# 6/6)-FM6.LI y4-NC City Bus. Lic.#O4 1p5— <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> _11 DikINE/L 9f5- 5 11 <br /> Phone/E-mail ric .vf. G. 11 'ia, . sona,,c6m <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK < e, eoe' <br /> Existing Use of Building MFG HEAT SOURCE: <br /> Proposed Use of Building M Ff& Gas Electric Other_ <br /> Building type: Single Family _Duplex Townhouse _Multi-Family % Commercial <br /> Type of project: 7-N.New _Addition Remodel _Repair T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> CvikiC a/OA./ cr r s 7r1C 7z- r m&,977 #c A 777x, •97/re/uavc -rim <br /> I) &/2-4-7 leg"r / 6. aiL.Pi46 r ,fitUJPAtn6.2 3 <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 /> • <br /> Water heater I Shower <br /> Gas fireplace I 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 I Urinal <br /> Boiler j Drinking Fountain <br /> Refrigeration _ I _ 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 authorized by the owner 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 /> Med— <br /> Owner/A2V/Agent <br /> Signa re Date (Revised 3/2013) <br />