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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERJDEMOUTION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-8857 www.everettwaorg <br /> SITE ADDRESS: _ PROPERTY TAX IfrT <br /> 7 7 b 4v--- e , ci r 1 o oo ori 6 a co 3 oI ► 1 1 k(�-nevo <br /> LEGAL for new construction: Short Plat/subdivision 61 C .-D.....0.0 Lot No. I$iMit/acicd }$of long legal description) <br /> OWNER S AJA.t,04 M. VO 1,(,,to*. Phone/E-mail J 44/ ,,'r`1 , U1/4/11 Lc,y!. I O`T, Cl 0(4.1 C• e,hAr <br /> Address 1 c c 1\ 670 14- 6)1e g-- Lf. City/State/Zip q ?, ),..c1 6 <br /> APPLICANT:T Owner Owner's Agent ontractor _Contractor"s Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTORJ -J e14e L ks 4- jh,,,4 , State Lic.# 4J&rie II e 7JNg...City Bus.Lic.# <br /> Address 9A <br /> -\d-k S:€ . 0 C (,o Cir. DAT-1,4,v 47191)-)--Phone/Email (sb2) o (&g <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> 4L / /f <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK o 1 e)1,0 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building 1 _. e:s__. ElectricOther <br /> Building type: —Single Family Duplex„Townhouse —Multi-F nilly / ommercial <br /> Type of project: New —Addition emodel _„Repair T. Sign_Sprinkler Dem. -- ” ange of Use <br /> DESCRIPTION OF WORK(additional space provided on the back)::Zits s t /47 l 6'41,,,i4,1beL. ,4. "' <br /> 4 <br /> -,Kra, d.i., ,,.....p"-*' '''i <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn jeAfteration_Repair Type of Project: _New_Addn Alteration_Repair <br /> 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 z. Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range 'shwasher <br /> Clothes dryer Clo s washer" <br /> s.--~" Range hoodWater'=-tef <br /> 1,,r^ Exhaust fan Sink( rvic. ear/mop/etc.) <br /> Heat pump Backflow preve -r <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other t Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> INumber 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 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 296200A WAC. <br /> X?—- <br /> Owne re t' Dat " (Revised 9/2014) /� \ <br /> I � J <br /> s j <br />