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RMIT APPLICATIOIP <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. verettwa.org <br /> PIS04 - 01 ) <br /> SITE ADDRESS: PROPERTY TAX# P RMIT# <br /> 1700 GrAN.o A✓e /17 e I c o�'t — a Ii <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Fa, . t-ivewtfz'rs r4012.cfLLc Phone/E-mail S ' � "3 c (00,1) v p <br /> 6 <br /> Address f O h�O$ 1 3 2-c 1 City/State/Zip veVC,t v" 4 • / g 26 <br /> APPLICANT:^Owner _Owner's Agent kontractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR ( A)ire N �fL II�J� State Lic.#UNITEP3 (4$R F City Bus.Lic.# <br /> Address 172° 1 &C A 7 PQ (001 SE 1, )1(oe• Phone/Email 3gO 79' j j 7 <br /> TENANT BUSINESS NAME ONTACT FOR ERMIT A <br /> Call 0 CA.X. 1.3A key Li Phone/Email 4126 7C I corf m <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 5-0 (-)QOM <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building hRe4" GasElectric K Other <br /> Building type: Single Family _Duplex_Townhouse Multi-Family _Commercial <br /> Type of project: % New Addition Remodel Repair T.I._Sign SprinklerDemolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Te/Y2,441L /fli pr izren c d P trit:� sL I` 7 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration Repair Type of Project:g_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 Z. Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Z Kitchen sink&disposal <br /> Gas range / Dishwasher <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 /> Boiler Drinking Fountain <br /> Refrigeration Z Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM / Other: 0(f (tje- <br /> Number of Heads 2- Other: I l e . <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 au rued by the owner 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 /> Owner/Authorized Agent Signature Date (Revised 4/21 <br />