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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: 2+�,rJfe f kc rog 'PROPERTY TAX# I PF 1111 t— <br /> LEGAL for new construction:ruG-Sthhort Pl�at//subdivision I Lot No. (attach copy of long legaldescription) <br /> OWNER M PE> 0 f-1/0 CG'+.-itR LiC. Phone/E-mail q-Z5-Z10v'-tWO <br /> Address v3 7Z(2 4City/State/Zip e/e2..Erri V.3 7A 0y120( <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 \\411(... e fj, (a�J(tate Lic.laiceN. 11'1((146(ger City Bus.Lic.#5----loe_t-t <br /> AddressI2 a.--.::: 58 L_e/ e 14-k Phone/Email (vvievA • . / eokk-V ,a )-\ <br /> TENANT SINES NAME k COIITACT FOR PERMIT 51AMS , <br /> 0141\1\ CEJ `C- ,%,), - mail GIWo <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK t6.2-P00.00 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric Other_ <br /> Building type: Single Family _Duplex Townhouse _Multi-Family .Commercial <br /> Type of project: _New _Addition Y Remodel _Repair_Ti.�Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> i usx-krt. VA-LA_ \AQ0,1QC asQoaci-%. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Addn _Alteration_Repair Type of Project: _New_Adds 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 �cl�j Medical Gas <br /> SPRI ' LER/SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby ce ' th- I have read and examined this application and know the same to be true and correct.At provisions of laws and ordinances governing this type of work will be comp) <br /> with whethe sp: 'ed 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, rized by the owner.f this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 298.200A WAC. n, <br /> /ift(Oti 7 <br /> A.0141 01 lifia.(4411 )11 <br /> Own_ /Ruth, izedA.. Sig - ur, Dafe (Rkiiised ) ;;: , <br />