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PES \ IIT / : PUU AT <br /> EZ UILD1NG/ ECHA QCA1=/PL.0B1 G/S1 N/SP1 I1 KL,E /DEG LITTON <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar Sjt.,,v�`Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: —�_ PROPERTY TAX# prpitfirr it <br /> (]/ E _-_,. 1. Oo Jo otoZ.70 Q C. 5 6- i <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of ling legal description) <br /> OWNER .11) V1''w?+ Ku !av Phone/E-mail k V IC --G.e 1'1 04 Wk©1 I,CO VV\ <br /> Address i 20 S 1�D I�l �4 se rAtrl f City/State/Zip (% -el\ WA G Ds <br /> APPLICANT: . Owner Owner's Agent .^Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR 564/it t:- 6G1/?QP69` d 'o/i /"/64CState Lic,# s-ekr/-)4 S 82 C j City Bus. Lic.# <br /> Address aor l - c.;, , e *.A! t--Z' r ' '� `I k0neiEm21/ /^6. iii j$D4-t�M.�c C..%.H,jl, <br /> TENAN?BUSINESS NAME 1_ CONTACT FPR PERMIT M alve r--WeL0\- -- <br /> 15516 5-64k Ave, w i r•gaW .f; tivi4 ggQZG <br /> MaheAtJefe;- 6-0(.0,11 ,C'o'.vc Phone/E-mail 'y. SU. tkiev ' ,w, I- , r.® <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK J �9J 74a-bl <br /> , <br /> Existing Use of Building-V v<k- �:../.5--e HEAT SOURCE: <br /> Proposed Use a : .;ing _ Gas Electric Other <br /> Building ty'e: •g.Single Family Duplex_Townhouse _Multi-Family Commercial <br /> Type of proje . 1 ew Addition _Remodel Repair T.1._Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back) <br /> Al $r ifq - f1- <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 fBathtub <br /> Gas piping4- Lavatory(wash basin). <br /> I I Water heater. i I Shower <br /> Gas fireplace ( Kitchen sink&disposal <br /> Gas range ( Dishwasher <br /> Clothes dryer t Clothes washer <br /> I 1 Range hood Water heater <br /> Exhaust fan I Sink(service/bar/mop/etc.) <br /> Heat pump <br /> Backflow preventer(inside bldg) <br /> I Unit heater Urinal - <br /> BoilerI Drinking Fountain' <br /> I Refrigeration Floor drain <br /> I Woodstove I Grease trap <br /> 1 Ducting I Roof drains • <br /> Other Medical Gas <br /> SPRINKLER /SUPPRESSION SYSTEM _ Other: <br /> I1 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 applicationliis made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> gf 712C,r5 i <br /> -Age" � Date (Revised 4/2015) <br /> awnerlAuthor'--■'Agent Signature <br /> . . ( 1 /97,4) <br />