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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.or <br /> SITE ADD SS: VV I�'�-01 ► `W� 9 YL�ii7 <br /> y►7 2J "'"A 'Or Ye- <br /> We <br /> c-- (PROPERTY TAX# 1 PERM( \-102„00 <br /> Qv- <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER WO -\ -—Ore_ /� ri�fi�y,�( AMIE-mail <br /> Address CAI <br /> `^, City/State/Zip <br /> APPLICANT: Owner Owner's( Agent V Contractor Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR CrOWn Vic?., Wot-et[ciniState Lic.# 031397 <br /> ‘;:t.) �.��� Oity Bus.Lic.#Addressi (-X \7,\� Milk ccee C t jhone/Email j„42c.L4 13)07(o q/ ^?5�TENANTUSINESS NAME J CO TACT' FOR/PERMIT IP! J cue�rOc <br /> �o 1� Ore C /0 s-han ACadesy Phon` a/E-maiJI�C.ek / Cr)Sil� raj <br /> t—E2. '1+6 mi 01 Cxi6h,QCso . Co <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ml <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building <br /> Gas Electric Other <br /> Building type: Single Family Duplex Townhouse Multi-Family x Commercial <br /> Type of project: New s Addition ,Remodel Repair T.II Sign!Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Asad- (jc ) 3r1n .A- ,- had , <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> . Type of Project: __NewAddn 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 <br /> Water heater Lavatory(wash basin) <br /> 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(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration I Floor drain <br /> Woodstove I Grease trap <br /> • <br /> Ducting <br /> Other Roof drains <br /> Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM I Other: <br /> Number of Heads I Other: <br /> • <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 authorized by the ow - .f t is 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 /> 61: 4, ./ ' liqi 0/7 tc t lot -o 01 <br /> wn uthorizec�Agen Signat e <br /> g Date (Revised 4/2015) <br /> (1-11-2.7 ", <br />