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• <br /> SER 1T APPLIC,4,T1 i <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 /> SITE ADDRESS: �PROPERTYTAX# _ pg RMIT# <br /> ere O2 EVEG-CEEN wh-Y 00efg02eo3ob-7oo t1 t _1( -00 _ <br /> Cicopy P )LIT --7' g'6,R <br /> LEGAL for new construction: Short Plat/subdivision NTS I •�� !� (�ttach of long legal descri tion <br /> �^ �-�j -•�p one/E-mail . <br /> OWNER M 1 /i t Irk) -c7 1(411_y {Nve§r pp " <br /> City/State/Zip a V ILL <br /> Address 66 oo *72 Nd) WE - MO- . . <br /> APPLICANT:_Owner _Owner's Agent _Contractor ✓Contractor's Agent _Tenant(must provide a letter of cones ! m the owner to rip work In the space) <br /> i ll <br /> CONTRACTOR 'i+d NI 6'V 1tN State Lic.# CC. gcl Al IL•1�l/j gr'L1p►�'�•us. Lic.#(�G�LI / 191 <br /> Address g 2�F2 S t 2 8 `,.e�t i & �1 A- ' `S t ` " Phone/Email �O��y �R b7lM ZO�� r c 1L�• <br /> TENANTBUSINESS NAME CONTACT FOR PERMIT 2,0-6 - Lis--g V,,,Q g�2 C•d <br /> Phone/E-mail • . .\afAv2. a S Above._ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK tScr Raft ,2.11__ _ 1 <br /> Existing Use of Building HEAT SOURCE: " <br /> Proposed Use of Building Gas 17 Electric Other <br /> Building type; Single Family _.,Duplex_Townhouse —Multi-Family VV Commercial <br /> Type of project: _New —Addition -Remodel _Repair \/.'T.l._Sign SprinklerDemolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): �Yt. ��WKk <br /> -1-1414-41471 <br /> G `re, g MAI) <br /> (Lo b 7400-10 aill&-114t, Otidg <br /> Pett- . 1NStAO-Ktr.. <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 /> NC-air handling units Toilet <br /> . Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin). <br /> { Water heater Shower <br /> • <br /> • , { Gas fireplace Kitchen sink&disposal <br /> Gas rangeDishwasher <br /> • <br /> Clothes dryer Clothes washer <br /> { Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump ( Backflow preventer(inside bldg) <br /> Unit heater ` Urinal <br /> { BoilerJ Drinking Fountain <br /> { Refrigeration Floor drain <br /> Woodstove { Grease trap <br /> Ducting l Roof drains <br /> Other I Medical Gas <br /> • <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 here". •r no 'he granting of a permit does not plesume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I am authorized by t '. - ••f 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 /> sent1- <br /> Owner/Authorized Signature <br /> . Date ie i7c14/21795) <br />