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lit'ERMIT APPLICATICR <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERE:006641011T SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> ty <br /> F <br /> aV. V3:0 <br /> SITE ADDRES�s: PROPERTY TAX# Rpm-L...,_, <br /> 1 1. src A,, 1c F\ .,r e 004110 1 "o0 o 1o6 VW t`7004 <br /> LEGAL for new constructioi. Short Plat/subdivision Lot Nod' ' ('attadh copy of long legal description) <br /> • <br /> OWNER , <br /> -+ Y I��� �j OY j �Oi U004 t om? LL C Phone/E-mail DO 10' 'J S /--1421 -. • . <br /> Address /401 b I ci •bkh st .9,7 ��,tt Do 6City/State/Zip (...Ar\ NJ if!")net Let 1 aft <br /> APPLICANT: S Owner Owner's Agent •_Contractor _Contractor's Agent Tenant("mustprovide a letter of consent from the owner to dP work in the space) <br /> CONTRACTOR 0 W fl C,ic State Lic.# City Bus, Lic.# <br /> Address Phone/Email NA J( ak J <br /> TERARTVISINESTIMIE CONTACT FOR PERMIT bOA <br /> c l` Phone/E-mail ` -)GSts36 <br /> OY ( 6 d r \'redDi (__Ar <br /> ti <br /> BUILDING PERMIT APPLICATION de' CONTRACT PRICE OF WORK $ 600.°2-. (522 <br /> Vag() <br /> Existing Use of Building • <br /> HEAT SOURCE: <br /> Proposed Use of Building Sc CZ, Gas_ Electric)( Other <br /> Building type: X 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): Ft $ <br /> 1%i nr�5 f ' �is t iwkex17 *(�- 0 0 �N r em ; <br /> / <br /> ad A (h)`<.r icy- c k-a\c5 end -�cc'4%°f.kn� Aeo (�u,�.�►-o n szittr-s <br /> , r MO > <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Adds Alteration Repair Type of Project: _New Addn _Alteration Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC-air handling units 40 Toilet • <br /> I Forced air systems <br /> I Bathtub <br /> Gas piping Lavatory(wash basin). <br /> Water heater I Shower <br /> , Gas fireplace r Kitchen sink&disposal <br /> Gas range I Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> • Exhaust fan • 1 Sink(service/bar/mop/etc.) ' <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater i Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting I Roof drains <br /> Other Medical Gas <br /> ' SPRINKLER /SUPPRESSION SYSTEM Other: • <br /> Number of Heads I Other: <br /> I hereby certify tha 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 s ified herei or no he 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 ized by th wn f 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 /> ') /Lac <br /> Owner uthorized Agent Signature Date :evised 4/2015) <br />