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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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: �)Q�" (; L I i PROPERTY TAX PERMIT# 6 <br /> d[ v J �J i1 /� 1.0 0 �— 0 ft <br /> LEGAL for new construction: Short Plat/subdivision. I C Lot No.1 0 (attach copy of long legal description) <br /> OWNER ira PGG flOmej Phone/E-mail 425 ?S '...2PC/4 <br /> Address /2 0 ..sid V ('f 111 City/State/Zip / I 2� <br /> APPLICANT:_Owner _Owner's Agent Contractor X Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work In the space) <br /> CONTRACTOR V/ h fi Pf h%2 IL&I:Lic.# Willfl r'L'J f l L COECBu}s..Lic.# Q514 ' <br /> Address /22 !Sid / a - ) ohoPhone/Email $� CJ V <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Av fr, 40 °]16 3 l 05 <br /> Phone/E-mail •/ A(C plump L! a Il. _ ii 1 <br /> 41. <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK etWri <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.l._Sign_Sprinkler_Demolition Change of Use <br /> DES CRI PTI ON OF WORK(additional space provided on the back): <br /> S libff /(9/ ) <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 /> L NC—air handling units L Toilet <br /> Forced air systems I Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water.heater Shower. <br /> Gas fireplace Kitchen sink Si disposal <br /> Gas range Dishwasher <br /> Clothes dryer I Clothes washer <br /> Range hood ( Water heater <br /> Exhaust fan I Sink(service/bar/mop/etc.): <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler I Drinking Fountain <br /> Refrigeration ( Floor drain <br /> Woodstove Grease trap. <br /> Ducting Roof drains <br /> Other Medical'Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> OOH I r 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 complied <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 authorized by 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 298.200A WAC. <br /> Owner/Authorii gent Si afore Date (Revised 6(2012) <br /> 111, E <br />