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I <br /> 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:1—et k 16,th Or <br /> S PROPERTY TAX# MIT tt <br /> LEGAL for new construction: Short Plat/subdivision pa Y W Cl 1`tS Lot No.Q9-9(attach copy of long legal description) <br /> OWNER Sect c"`"('G L Homes;. Phone/E-mail 1425 9.65 Z 'C3CO <br /> Address ‘20Svc) ��L�� 1��WCk� 41 100 <br /> City/State/Zip GAN(2,i'�, Wt�r q?20 <br /> APPLICANT:_Owner _Owner's AgentLContractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR F4dal�12G1 I(/fl b/,1 )tei ►og State Lic.# At 'Avsjp.'j17.5 City Bus.Lic.# <br /> Address i k22 P f Glahr 4 /3i,ti,Sof i k fD: S Ao horn 1 s f.lM4 Phone/Email q'ZS" 314 q 51 DC <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail 25 — E-3100 51O® <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 7 47 Pg. <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): t 055 <br /> attfi f/tD2- 5aP, -1(1 <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 /> az I 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 authoriz y the owner of this property toperform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> rz� /V/A ' 17/12// i <br /> Owner/Authorized Agent Signa uri a Date (Revised 4) <br />