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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: PROPERTY TAX.. PERMIT# <br /> 1;1, r7g4t, `l `Z�`5 .3.�zet z' 3�t toe f R16o4-040 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal/ description) <br /> OWNER ,61.6tb fl FOWL, 2c.iv.H c'& Phone/E-mail ti �4h '"limo j�C LQ&i Ege " i7 -kr <br /> Address CO j City/State/Zip g" el(.y� J 1 6 <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 ---44-2 PaCr f C MObode_ State Lic.#PAcj P MStt31 DC City Bus. Lic.#OSf Z�Z <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT! <br /> Phone/E-mail 1,r7e 5'r�..7`�""7� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �(�( �/Cx'C <br /> Existing Use of Building rct$LiC 5e Ce. A -7 HEAT SOURCE: <br /> Proposed Use of Building j Std F ce,,,,,firAry Gas_ Electric X Other_ <br /> Building type: _Single Family Duplex_Townhouse _Multi-Family )Commercial— S —14 "1— <br /> Type of project: X New _Addition Remodel Repair T.I._Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Ar 0) '4 1) ML? 55ran-1 c4V ? <br /> ��z'li t tJt - 06 A-4't7iL'( <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 /> NC—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 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 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 authorizecyby 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. 1 <br /> IFALs 7z <br /> 0 •r thq ized Agent Signature Date (Revised 9/2014 <br /> f <br />