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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 ADD ESS: PROPERTY TAX# PERMIT# (� <br /> X15 i wc.il.r-eo'73Lud a901-1 3locblo II 1-100A1\ t nO� °UZ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER 1.4..„.t . A a ic,,r-S -��'7,,,,eL► I.,, e Phone/E-mail 7 L&1...4-v:044,-,41-13... "3/--.) 0815/ <br /> . <br /> Address 'i�D'2}p)xa..j ..'-') City/State/Zip ,e. LtivA 4"31 a..) 3 <br /> APPLICANT: Owner _Owner's Agent X_Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 'f4.1-1:)Wti,e Fire 4- Set a-1,' State Lic.# PkL.a ryFSef?-7j1.p City Bus.Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> oi'`-'. L''0r3 L r4r\ +-ur "f ✓e-r-Z.D15//>_'arl-r•01 1'\ 7) y— <br /> Phone/E-mail -1--e„(:),0a 0`,Ae_ ee —756 51-1L/ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK IS 6" 01^11 <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 Remodel Repair_T.I. Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): pc..y 4 �1s- � —7 t (ter- Get I4�_ <br /> rf er,,n �`�'� e'+ <br /> . . M - -~ ' Air- i.e.it7T Fon— 7()1'e o 0 / <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 /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Y/ 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 /> Y Ductin Roof drains <br /> Other I NMkt.— Are Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> rkir is 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 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 /> wner/A thoriz-• s• - -.,.....-�.- Date (Revised 9/2014) <br /> I <br />