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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# RM <br /> '2. 11-.1 - 8 5i - - OOr-kcri.IOQ�c Cc rl -0-C <br /> 44 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER \.k1 II-U/6\11 Et t- EjZ t A--(LDZ. Phone/E-mail <br /> Address 214 - 5 --I— City/State/Zip E--0. -rr't ' 1�Zd1-1 I LoO <br /> APPLICANT:_Owner 'Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owne rc in the sip <br /> CONTRACTOR ElEj 276.1. Lp LTI State Lic.# ENIE(Z( �4 19tE - `�, City B s. Lic.#114 1 (06 <br /> (y25)34,1-o8F-fl <br /> Address 2...S1 cSIZ-r ,tjl,.�p."--( ,S1C2l -1r, 1/.3A. 9 37 p1 Phone/Email eJcry'Cc'1Con-hfL-c-tyto .MSt' rV <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT J <br /> 1J�t�-mss n,L,•acr�r�- <br /> 602 S$ mutt KtU,�c beA�,r��---�t�r4. ( 3-- v <br /> Phone/E-mail ctor.tct•ca-t'V c(@ -- ow- Co <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF K 4 e eo <br /> Existing Use of Building 5IP.La .l 1-'AM\--ttt._--4 far- ct•lezeHEAT SOURCE: <br /> Proposed Use of Building *.nit-- Gas_ Electric_ Other <br /> Building type: Y.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): <br /> EN.v. -O G1-tsilrl..L, CAK.?cD(L'i t,...ab U-L- FlEk-iE.0 C.,A -.A.[a>=-. <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&dis•.sal <br /> Gas range Dishwasher <br /> Clothes dr = Clothes wa er <br /> Range h•0:1 Water h=-ter <br /> Exhau,- fan Sink -ervice/bar/mop/etc.) <br /> He- pump B. flow preventer <br /> U it heater rinal <br /> :oiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap _ <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRI LER/ SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereb 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 compl <br /> with,hither specifi-d herein or no e gr- ing 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 /> Th- I a. - thorizl•by t •wner of this prope. to perfor.• e work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> • 4J4 1 /O . 2o• 2.OI-L <br /> Owne ,t ori ed Agent Signature Date (Revised 9/2014)! 1 <br />