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,. • <br /> 4 <br /> • P P MST APPLICATION <br /> • <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: PROPERTYTAX# PERMIT* <br /> 2tit 44xErzsod (60,0I -059- <br /> LEGAL,for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER (jt4 %2 --f,3pL Phone/E-mail q25-.-q(11_ 03,1 5 . . <br /> Address 24.4 AU.Vio City/State/Zip EUrear wA *2-0/ <br /> APPLICANT: Owner _Owner's Agent 1( Contractor —Contractor's Agent —Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR Eta 6 P41;---N "TAc 426116111C,.. State Lic.# E,VEt O22-0T • City Bus. Lic.# Ci01155 <br /> Address 2t-2.0 tictaC {moi . e.V . w•4 ct 9¢.0( Phone/Email 4-2_S-, 2s2 3 L(t <br /> TENANTBUUSIt�IESS,NAME CONTACT FQR PERMIT . <br /> ATB <br /> 6 Mika e S .u'4.Edi <br /> Phone/E-mail 4-1-5.-25-2-3//Y <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /g�of D <br /> ` EXisting Use of Building -G'e,( - COC 'e...btoicze HEAT SOURCE: • ' <br /> • <br /> Proposed Use of Building 't -ND c'I'"'(.e Gas Electric IC Other <br /> Building type; X Single Family Duplex Townhouse Multi-Family Commercial . <br /> Type of project: New Addition _Remodel k's_,Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): • <br /> • la.kV& GX-.S-r(&( Cvo,t4 aJ MI. ttioa AQP . <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 fixturesShow Number(#)of fixtures <br /> NC-air handling units Toilet . <br /> Forced air systemsBathtub <br /> Gas piping 1.41:latory(wash basin). <br /> I Water heater � .Shower ' . • <br /> _ <br /> _ . Gas fireplace Kitchen sink 8i disposal <br /> Gas range • Dishwasher <br /> I Clothes dryer Clothes Washer <br /> Range hood Water heater <br /> I Exhaust fan f Sink(service/bar/mop/etc.) ' <br /> l I Heat pump Backflow preventer(inside bldg) <br /> I Unit heater Urinal - <br /> I Boiler I Drinking Fountain <br /> I Refrigeration Floor drain - <br /> Woodstove Grease Trap <br /> I Ducting - <br /> Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> Number of Heads • 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 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 296.200A WAC. <br /> <---1Q0'11 .--- ,1 (6 , rG <br /> Owner/Authorize nt SignatureDate (Revised 4/2015r <br />