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PERT 1T A PP1JJC k.T <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.Org <br /> PROPERTY TAX# PFRnrtc' <br /> SITE ADDRESS: in C) 20 0/0 Z..7d o D „Ord <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of Ilbng legal description) • <br /> • <br /> OWNER .Aileivt,,,,,,:f Ku t o.ee Phone/E-mail K V ka-ce-•,, k o+W ft cD vv\ .. <br /> Address iJ I bl S P City/State/Zip C' -Gl--\-•. UV A /(_,G Dg <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 /.C—' 66/074/1617/107747-0,41 c--C State Lie.# Se47T <br /> -64 S 82 C- f City Bus. Lie.# <br /> Phone/Email� ���/^��/���SD�ttfr'�ES 01-Mg, <br /> Address 2.� /30 — • S,e i'At L--ti / `L$/k N-0,2 I( <br /> TENANT BUSINESS NAME - V f - CONTACT FOR PERMITg �� tA,,�ct��lner--�}wetex <br /> ,.r P 5516 S6` 1 fie. w G�- OVtj; wl4- ggoz6 <br /> Mahet-N/e'fet..,,• 4� MA=t) ,Lc?vtn Phone/E-mail 141 SU . ry&-c' 1 H' t , c,„, ' <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 0591 r7t-teat_ hfac <br /> Existing Use of Building V(:(Ge•Lv\k- \-9..1ye HEAT SOURCE: . <br /> Proposed Use o = Gas_ Electric Other <br /> Building ty+e: .)Single Family-Duplex Townhouse _Multi-Family _Commercial <br /> Type of proje _ 'ew Addition _Remodel •_Repair_T.l._Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> /liEi ,-S - Tri -fib <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 -3 1 Toilet <br /> • Forced air systems I Bathtub . <br /> Gas piping. 4. • L4Yatory(wash basin). <br /> I I Water heater. i I Shower <br /> Gas fireplace t Kitchen sink.5 disposal <br /> Gas range ( Dishwasher , <br /> I Clothes dryer ( Clothes washer • <br /> • Range hoodWater heater <br /> 4- I 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 /> 1 Woodatove Grease trap <br /> Ducting Roof drains • • • <br /> I Other Medical Gas <br /> SPRINKLER /SUPPRESSION SYSTEM 1Other: <br /> rNumber of Heads Other: <br /> I herepy 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 /> `/7/ s <br /> (Revised 4/2015) <br /> owner/Author'--+"Agent Signature Date —7., <br /> . (\ /1/2-- ,,/) <br />