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I'ERMIT APPLICATIO <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 ADM*, \N 1PROPERTYTAX# ` <br /> ow—,..1 \..\ <br /> v , PERMIT <br /> 015 ' <br /> ,h <br /> LEGAL for new construction: Short Plat/subdivision \�nv Lot Nt, (attach copy of long legal description) <br /> cT <br /> OWNER `70 ` C_. \-1/`6�'e nPhone/E-mail LA S• (l ct- b^ '`"t y 9 <br /> Address \j-j�l \ h� `V Neve 1"8i1tate/Zip —7/v`e 1(i'Q ' \ JO lS)r <br /> APPLICANT:_Owner _Owner's Agent X Contractor _Contractors Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR V► ('(���C��S{A^ m �n tate Lic.# VN�fi CCY `�(QCity Bus. Lic.#D yro54' <br /> Address 1\ f• T Q"1 } '' Si— i Y1\\Yn 17 (� <br /> �„1,3 Phone/Email �utb-Lib`S_ t C.�t., i <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> i <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 3' T O •(P <br /> Existing Use of Building HEAT SOURCE: <br /> i <br /> ' Proposed Use of Building GasElectric Other_ I <br /> Building type?< Single Family _Duplex Townhouse _Multi-Family —Commercial <br /> Type of project: . .New Addition Remodel Repair_T.I. Sign Sprinkler_Demolition_Change of Use ' <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> '\&,\N cc,% v\oc OY\. \V_ %.?Yk o .,v <br /> 1 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION ! f <br /> Type of Project: _NewAddn 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 /> r <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal j <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 <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain I <br /> Woodstove Grease trap , <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> I` I Number of Heads Other: <br /> I hereby certify hat 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 corn)I I <br /> with whether p,ecified 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 constructio i <br /> T -t I a a •'zed• -• y 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/• ,thori;d Agen ,.ature Date )(Revised 92014) <br />