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. IER iT PPUUCAT d <br /> • <br /> CITY OF EVERETT PERMIT SERVICES <br /> ®�/� <br /> 3200�ICedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.Org <br /> "WELT d /g " " / S , - PROPERTY TAX ft pFRnmz <br /> SITE ADDRESS: A. <br /> . '� >~ Ever,._ (,t/,4 o,0 5.3 Zo o l o 2.70 0 .C✓15J'1.6 -03' <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Mnw e+ Ku tate phone/E-mail KV`ck -G\g k 0+1114.,0.11,CD . . . .. ... <br /> bilk <br /> Address 12.0 S 1?)b i bl S c,E ( <br /> r 'i City/State/Zip ly\er-6. A c Ds <br /> APPLICANT:_Owner j/Owner's Agent Contractor _Contractor's Agent _Tenant(must provide a leiter of consent from the owner to dp work In the space) <br /> CONTRACTOR5e4 /C t' C'c-i1 QP// T/f 2T/t7S AV( 4 State Lie.# S-ek'rT--54 S 82 C..f City Bus, Lie.# <br /> " ' JPhone/EmaflftJ*/ �/C// SOhffd��Sirlf/tjC, <br /> Address /42,5--- (307:5. �; Se t'A L� /14 /'k ` 'i ^ <br /> TENANT BUSINESS NAME I CONTACT FOR PERMIT tAckiAp _WeLa,t'_c2 <br /> 155/6 5-64k +4/e, in/ v1ov4,-; wiq- gs026 . <br /> MGther- era,' GYYNat) ..001,1/\ N Phone/Email.It s'tj _ ,tteN: ' a-M' i , r.0 1--A <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 1591 e71-4.0.- hWA <br /> Existing Use of Building V aGe.v,k-- -i9:_i3-e HEAT SOURCE: <br /> Proposed Use o : .• . Gas Electric Other <br /> • <br /> - <br /> Building tyle: Single Family, Duplex Townhouse Multi-Family Commercial <br /> Type of proje . 'Jew Addition —Remodel —Repair—T.I._Sign__Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> /UEtti `5F1Q — Arri?ifTb <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 -..? I Toilet • . <br /> Forced air systems I Bathtub <br /> Gas piping 4. La'atory(wash basin). <br /> t Water heater. I I Shower <br /> J Gas fireplace ( Kitchen sink&disposal <br /> Gas range t Dishwasher <br /> I Clothes dryer 1 Clothes washer • <br /> i Range hood Water heater . <br /> Lr; Exhaust fan I Sink(service/bar/mop/etc.) <br /> • Heat pump ' Backflow Prev-enter(inside bldg) <br /> Unit heater Urinal . <br /> Boiler •I Drinking Fountain <br /> Refrigeration Floor drain - <br /> Woodstove J Grease trap <br /> i Ducting I . Roof drains <br /> Other Medical Gas <br /> r SPRINKLER /SUPPRESSION SYSTEM Other: _ .. <br /> 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 application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> s/77zo,'S <br /> ..;•-•-_..,. Date (Revised4/2095) <br /> +caner/Author' Agent Signature <br />