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l• ! ;,AT / PPL CAT Of <br /> .,UILD NG/! ECHAI .1CAL/FLU NG/SIGN/SP NK LER/DEMODUT1QN <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 - `r F /S - t PROPERTYTAH# pFannrr 16 <br /> SITE ADDRESS; ^ / O©3 Z o t7l n 7O L• _ D <br /> ,4 3/ K/3i, 6t`3 p/ ; Eve.;— <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER .Al )i-1v\-e+ Ku 1aCOq Phone/E-mail kV la --A 0+*kat 11..,CO VI/\ . ... <br /> Address 120 S 12,bilik. S 4 S'- 4 1. ,4 _ City/State/Zip W)4 <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 /> CONTRACTORS I /L t= 66-Vetptigtir itifir'triDa teC State LIG,# Seki 7_64 ss2 C F City Bus. Lie.# <br /> Phone/Eil kr/0i-6 401 504-#t7 i-s aolio <br /> &=; <br /> Address aor l0 75. • c_ i' �—y/ r� � `�I ' Ima ! <br /> •I ` . -, r CONTACT FOR PERMIT ��a�� <br /> . 155/6 5-0► 14v 4 , wi4 ?502,6 <br /> Maher-Vera,- &rn.o4) ,c0,4" )Phone/Email.1.1 56 , ,.i -M i , r.� t-? <br /> • <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK / 591 '71 01.. ha/ <br /> Existing Use of Building \I GCC .v�� 'IN.t/..)s..d HEAT SOURCE: <br /> Proposed Use a : 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 Ec4) 5 F - /4-7-71/-0/Q) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Adds _Alteration_Repair Type of Project: New_Addn _,Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC-air handling units "3' Toilet <br /> . Forced air systems I Bathtub . <br /> Gas piping 4- i l Yatory(wash basin). <br /> 1 I Water heater. I I Shower <br /> Gas fireplace ( Kitchen sink&disposal <br /> Gas range ( Dishwasher <br /> 1 Clothes dryer _ t Clothes washer <br /> ' I Range hood Water heater <br /> Exhaust fan • <br /> Sink(service/bar/mop/etc.) <br /> I Backflow preventer(inside bldg) <br /> Heat pump - <br /> Unit heater Urinal - _ <br /> I Boiler _ Drinking Fountain <br /> I Refrigeration Floor drain <br /> i Woodstove I Grease trap <br /> 1 Ducting I Roof drains <br /> . I Other Medical Gas <br /> SPRINKLER /SUPPRESSION SYSTEM Other: . . <br /> I 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 19.27 RCW and 296.200A WAC. <br /> • Owner/Author -■'Agent Signature Date (Revised 4/2015) <br /> • • <br /> (1. ,,k_.) <br />