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PERMIT PPU CATL <br /> tUILDING/MECHANICAL/PLUMBING/SION/SPRINKLER/DEMOLITION <br /> ' ' CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 08201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> _ (510" - <br /> SITE ADDRESS:_ PROPERTY TAX# PERMIT 6d9- F(J w Qw `s4° " <br /> LEGAL for new construction: Short Plat/subdivisionLot No. (attach copy of long legal description) <br /> OWNER MPf t F• `r/LN ,$ f'fiNL`d (NVe)?/he 0 Phone/E-mail <br /> Lc-cr <br /> Address kW O 721)0 D(t. P t-/ 1y^R+`hf Jt c,c-e M- h b ted City/State/Zip <br /> APPLICANT: Owner _Owner's Agent kContra.ctor _Contractor's Agent Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR (06-Ukft--41 State Lie.# C C S UV f/gTeLie.# <br /> Address 6 2 2 S 1 2 p ggek-` `& w r"` 0 ( 7 g Phone/Email-4, —0D r5bke� <br /> Aha <br /> TENANT BUSI ESS NAME CONTACT QR PERMIT /// • ( <br /> 201(�J.yam. i <br /> Ot ) P e41- Phone/E-mail ' <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK `l 000 <br /> Existing Use of Building Aha^au'`et) 'fe f f c wt..r`r HEAT SOURCE: <br /> Proposed Use of Building Gas= Electric Other • <br /> Building type: Single Family Duplex Townhouse _Multi-Family AZCommercial <br /> Type of project: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler C Demolition Change of Use <br /> DESCRIPTION OF WORK(additional spaceprovided on the back): <br /> V 6-f74,1 A/A ae•ar ti�� �-1 Pte- r- - n. �a ovc.L �J <br /> C0114 014. r n' " IN(€ tOeL. f/J 0 e1cit.1OR.- AwMtUc, 0/0 LAI . <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 systems I Bathtub ' <br /> Gas piping Lavatory(wash basin). <br /> I Water heater I Shower <br /> • Gas fireplace Kitchen sink&disposal <br /> I Gas rangeDishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> - I Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow Preventer(inside bldg) <br /> Unit heater Urinal <br /> I Boiler Drinking Fountain <br /> } Refrigeration Floor drain • <br /> I Woodstove I Grease trap <br /> i Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/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 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 author'y by th-�'wner 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 /> �, OCT"— w .-2°( <br /> Own rlAutho1zed Agent Signa Date (Revised 4/2015) <br /> r' <br /> • <br /> • <br /> ��Z <br />