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PERMIT 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 /> SITE ADDRESS: PROPERTY TAX# PERIWT# <br /> /7/0 P/N/e sr cor,o64006oItoo (703-C% <br /> viCrelaY ADP <br /> LEGAL for new construction: Short Plat/subdivisionAeje7.1- gaoot p 00 Lot No.// (attach copy of long legal description) <br /> OWNER ON /2/ tee gN6. Phone/E-mail 4125 157 9/77 <br /> Address /7/6 City/State/Zip -V.ER0rr tog. 9820 <br /> APPLICANT:_Owner _Owner's Agent X.Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dow r • <br /> CONTRACTOR EVt2ETT 13u/L.E125 /A)C, State Lic.# ;EVEeea 301 P1-) City Bus. Li 007 <br /> Address 2418/8 43RDA-t1E A),. ,¢R..h/A) .7 AJ UX¢ Phone/Email 2/2S-353- M01 <br /> TENANT BUSINESS` N <br /> jNAME CdNTACT FOR PERMIT -2 <br /> �/t/ 6/45,e5 //)C Phone/E-mail s ✓5."--3 7/i( <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK( 23 7'73.°O <br /> Existing Use of Building /-rA-R 6-A,P4G HEAT SOURCE: <br /> Proposed Use of Building E,rtG4,e6e, 74,64:1 'TO Z-Cite 64e. /(/Q,I/E Gas_ Electric_ Other <br /> Building type: _Single Family _Duplex Townhouse _Multi-Family Commercial <br /> Type of project: New >(Addition _X Remodel Repair_T.I. Sign Sprinkler V Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): \\ / <br /> Pew°- �, G etc- ,k/ly zo / / CAe 4 4i).0 /0 x Zr, 'TD EX/57: <br /> ft1j fsC 6/¢T7 7t) € 1461--ME 24 fx 20 f Z-e4- .o.01-441-at - <br /> MECHANICAL <br /> o.'` t - <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 /> AAiRange hoodf/ f� Water heater Exhaust fan �V 7 J Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer . <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain • <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other ' Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> 1 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 whetpef,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 arria4orized 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 />