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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> ZG�200 Cedar St, Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.'e/'veeri ttwaagrg � <br /> SITE ADDRESS:N-inT I HOU <br /> O f n (.5 ' <br /> ' oe'e P5PnoC 00 P R IT# C- <br /> LEGAL for new construction: Short Plat/subdivision Ii.l(ICI(!I(' Lot No.Li() (attach copy of long legal description) <br /> OWNER C,‘.._Pat, OrreS Phone/E-mail a r 53 Z IS 60 <br /> Address 130 19 Sl 1 41. 1J /) f 103 City/State/Zip 2 9 zof <br /> APPLICANT:_Owner _Owners Agent " Contractor _cb �� <br /> ntractor s Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR ���Sg <br /> k,t4 If 2 h State Lic.# ilfge4 H / 'tI b City Bus. Lic.#010406 <br /> U3 <br /> Po�X � <br /> Address 0 LGt�,�Cl1caS G�i Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT L.I 564 Wck h I b J J <br /> Phone/E-mail Li 2 c 339- /II 1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK Lpa(� , <br /> Existing Use of Building S4 1n2 HEAT SOURCE:�/ <br /> K <br /> Proposed Use of Building S f Gases Electric J�. Other <br /> Building type: _Single Familyc _Duplex )(Townhouse _Multi-Family Commercial / <br /> Type of project: '‘)/New Addition _Remodel/ _Repair_T.I._Sign ___ <br /> _Sprinkler DemolitionChange of Use <br /> DESCRIPTION OF WORK(add i nal space phon the back): Jn a 'n c-/o � he eij, <br /> jilS*1 /1 d ticf/r`rS Ii I�x-t Wt <br /> ar\a / Ou1dooon, <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> t Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC—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 <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 1 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 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 a . orized 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 296.200A WAC. - <br /> (?-2b-/p A, ?� <br /> a n'Autho tze A nt Signatur Date (Revised 9/2014) <br />