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• <br /> PERMIT PLIC TI <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 vwvw.everettwa.org <br /> -49 1 t1 kt" OR 'bE <br /> - <br /> SITE ADDRESS: PROPERTY TAX# (�Q PIT —O <br /> ,, <br /> LEGAL for new construction: Short Plat/subdivision 4I ?t n'G 1�}S Lot No.�1Dt7 (attach copy of long legal description) <br /> OWNER SeCtilkg { i Ca. \OO\f S Phone/E-mail q21.5 9.5-) 4 goo <br /> Address ‘2.0 Silo) \Je -reavAel +4100 City/State/Zip 17—'4 f4.i+ 'N14 CI?20111 • <br /> _— <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 Maittad 01011by 112M41110 el State Lic.# AAN AN PO 3LS City Bus.Lic.# <br /> Address ct&r:,t pike,aide,ID; i,ohomish im774. Phone/Email ITZ,S- 3 Li 5i 00 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail L1/2.5 — 00 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OFWORK • Y1 P. 60 <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): UP--0(12 <br /> r _0r - O' <br /> ritt (41 ._ t $ p <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 /> 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 s a-cified 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 a .'orized by the owner f 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 /> e <br /> el/ let/4//2 <br /> 0`z. �. <br /> _ O ne •uthorizedAgent St nature• , ate _. _ :(Revised 094)- <br />