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• <br />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.or <br />io -d -/i/ <br />SITE ADDRESS: <br />r-/US SE C—never/ /✓IceC <br />PROPERTY TAX R <br />8o sr8 a�3 OvIUO <br />_ _ <br />=-vD <br />LEGAL for new construction: Short Plat/subdivision Lot No._ (attach copy of long legal description) <br />OWNER % e% 7 =U337 <br />1chonelE-mall <br />Address f9e) /hex 9v-1-6 <br />Cily/State/Zip {4i;nnec.,00/%r rYJn. »y`10-Q`/�� <br />APPLICANT: Owner Owner's Agent ✓Contractor Contractois Aienl _Tenant (.5l provde a inner of concern tram To owner:o dowoa in mo space) <br />CONTRACTOR L G+K ror2/ l�/u.e-n6«w &,c . <br />State Lic # L141VG t= d f O `+'Y2Y City Bus. Lic. # <br />Address V-IUUy /VE //S{'^ 5A• Qedenci el CJa QQ6S3 <br />Phone/Email '-1;1 n:Z o36 / <br />TENANT BUSINESS NAME <br />j a Jew / S�evbe e /cs <br />CONTACT FOR PERMIT <br />Phone/E-mail O :�06 116! 6 V H0 <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building_ Gas_ Electric__ Other_ <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 bate): <br />Zrr�e�7'or�-fe�,a.�,F /an�t3rnve.-.venF. f�ror�r�/e `{i�sla� �+G:N� �r S/avb�ucks <br />5kove , <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING ERMIT APPLICATION <br />Type of Project: _Now _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Typo of Project: _New_Addn YAlteration _Repair <br />Show Number i or fixtures <br />A/C -air handling units <br />Toilet <br />Forced air systems <br />Bathtub <br />Gas piping <br />/ <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />Gas (replace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />a <br />Sink (service/bar/mop/etc <br />Heat pump <br />0- <br />Backfiow preventer <br />Unit heater <br />Urinal <br />Boller <br />/ <br />Drinking Fountain <br />Refrigeration <br />3 <br />Floor drain <br />Woodstove <br />{ <br />I Grease trap <br />Ducting <br />) Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />( <br />Other: t,joi 7k<ti sLcx,.r. <br />Number of Heads <br />Other: <br />I hereby certify that I have read and examined this application and know the some to be true and correct. AA provisions of laws and advances governing this type or workwi2 be complied <br />with whether speared herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision of any other state x local law regulating construction <br />Thal 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. � 1 <br />'�d�- 2 <br />Owner/Authorized Agent Signature - Date (R.!vised 212013) <br />