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IERMIT APPLICAT1 <br /> BUILDING/MECHANICAL/PLUIVIBING/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: PROPERTY TAX ft P RMIT# <br /> 3'321 FAQ€ML Aye u T LAA- 0 t ) b1-0D2- <br /> LEGAL for newTconstruction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> • <br /> OWNER UQ C' �..� Phone/E-mail �`/,�r s-Z g-Yo g Gr6��S <br /> 6e5e C <br /> Address 3?? "1 ,�70Rx.4L 4r~e_ City/State/Zip cv � Gam_, 9g7nr • <br /> APPLICANT: K Owner _Owner's Agent _Contractor Contractor's Agent _Tenant(must provide a fetter of consent from the owner to dp work In the space) <br /> CONTRACTOR Q e,,rj,A,,(Z State Lie.# City Bus. Lie.# • <br /> Address • Phone/Email <br /> TENANT BUSINESS NAME CONTACT FQR PERMIT • <br /> Phone/E-mail ' 'FL/9 ,4/i.5 t4;.444 L_ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 2j p® .Oc- <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building - Gas Electric Other <br /> Building type: &Single Family _Duplex_Townhouse _Multi-Family Commercial <br /> Type of project: New _Addition Remodel _Repair—T.I._Sign Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): • <br /> ea1c c� ►1rxC(\ 1, mo.f.L '994c�- f ri_,.. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: New_Adds 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 /> r Water heater I Shower <br /> • I Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer • <br /> I Range hood Water heater <br /> Exhaust fan • 1 Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal • <br /> Boiler _ Drinking Fountain <br /> I Refrigeration Floor drain <br /> Woodstove I Grease trap <br /> I Ducting I Roof drains <br /> I Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> • <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 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 /> , ner',ner horized Agent Signature Date (Revised 4/2015) ,- <br /> �• <br />