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fERMIT APPLICATION <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 /> P15O'o6? <br /> SITE ADDRESS:61 00 �. n /t PROPERTY TAX# PERMIT# <br /> LEGAL for new construction: Short Pll_at//subdiivissiioonn Lot No. (attach copy of long legal description) <br /> OWNER 41,u,.., Alywm,64,4 %j7 icA^s atI kI..T Phone/E-mail 41.75--50 -t -(600 <br /> Address 2611 gra, Ave, d" 3 6� City/State/Zip �`I T&/Ad-)4 .7-6 I <br /> APPLICANT: Owner _Owner's Agent %/Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR () /1W_ (fl l,t/YtSttate Lic.# 0NiTF P #lyg (2 City Bus.Lic.# %C(t�4 <br /> Address 1110 0.. RI. �/me,itc.trc wile al g'V11- Phone/Email 366-7�1�-5'33-7 <br /> / <br /> TENANT BU INESS NAME CONTS ; PE- ,IT r 'Ji Pet'YYlav► �ZS--s7 7— <br /> (4- <br /> fib- �� - qf ll0I <br /> Phone/E-mail �"-,` tJ Wt4GJ(b�iLt 'LF1Y`'' <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 40(9 0 <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: _Single Family _Duplex Townhouse _Multi-Family X 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 /> T N ct J I WI r rr v m e-". - S, s v U J gc l k-1-- eq c"1P6t.a,,,,;f <br /> co .. N Q- 6cAlakti✓- . '- .r <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 /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood / Water heater <br /> Exhaust fan A Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bids) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration I Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certify that I have re- ••exa 'ned 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 wheth •. hied h• ,r not.The.ranti.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 a- author', . .- 11er. ••erty to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WA . <br /> IIIV <br /> •q=gr. • orize. • •ent Signature ate (Revised 4/2015) <br />