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• PES.,..,s T*PPLICATE—A <br /> • <br /> g.UILDING/MECHA .MAL/PLUMBI G/SIGN/SPRINKLER/DEM LITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> .( : 'j 4 ' OP /S <br /> SITE ADDRESS: PROPERTYTAX# . pFRMIT <br /> . / a/i. • , : - n - A i Cos 20 lata Z.7O 1 ©`" <br /> LEGAL for new construction: Short Plat/subdivisionLot No. (attach copy of long legal description) <br /> . <br /> OWNER .A Y 11", Ku tc,.v Phone/E-mail kV lace,_G e k 0-1-W 1 I sC.Dvv\ . ... <br /> Address 2o l� 1°` S- S P City/State/Zip C> G �/14 J(7 (�s , <br /> APPLICANT: Owner /,/Owner's Agent Contractor _Contractor's Agent —Tenant(must provide a latter of consent from the owner to dp worts In the space) <br /> CONTRACTOR Sh4I 71 G°' 6601-Q R1V(97747 0/t/c State Lie.# je*77-L)4 S g2 c F City Bus. Lie.# <br /> ( ! �2c/ /-64/x////.5dil- -dtifca�=H/4y4, <br /> Address ��.� (30 - p.;, ?,CL �'A ��t�/ �� all�`�� I <br /> Phone/Email <br /> TENANT-BUSINESS NAME — CONTACT FOR PERMIT Malker_ e[pl,L . <br /> 1 I 155/6 56`4114Vie. w �.ovi - W) - %gort • <br /> Maher-Vela., GV1� \- ,Cc vV\ Phone/E-mail 'it SU . /i6- 1 >H' L" , c ' <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 159), rillea._ ko.1 <br /> Existing Use of Building V cceA.v<k- \ —e 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.I._Sign Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Al ti) $ , - 1 T��b <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 fixturesShow Number(#)of fixtures <br /> NC-air handling units "3 •• Toilet <br /> •• Forced air systems ( I Bathtub • <br /> Gas piping 4. Lavatory(wash basin). <br /> I I Water heater. 1 I Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range • <br /> ( Dishwasher <br /> I Clothes dryer 1 Clothes washer <br /> I I Range hood Water heater <br /> �r Exhaust fan • j Sink(service/bar/mop/etc.) <br /> "C Heat pump Backflow preventer(inside bldg). - <br /> I Unit heater Urinal <br /> Boiler Drinking Fountain <br /> I Refrigeration Floor drain <br /> I Woodstove Grease trap <br /> I Ducting ( . Roof drains . <br /> I Other Medical Gas <br /> SPRINKLER /SUPPRESSION SYSTEMOther: <br /> Number 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 forwhichapplication isf�m''ade and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> iwner/Author'--■Agent Signature Date (Revised 4/2095) <br />