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PEL1T /APPUCATGI <br /> UILDING/MECHA ICAL/PLUMBING/SIGN/SI RINKLER/DE LOTION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St, Everett, W4 98201 425-257-8810 FAX 425-257-8857 www.everettwa.Org <br /> SITE ADD SS: PROPERTY TAX# . rFF�nntT ` ' I <br /> . ■ . , .. - .� � A7 a©� Zoof°Z7d p <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of <br /> _long legal description) <br /> • <br /> iw <br /> OWNER A e± Ku taii5k i Phone/E-mail 1 UFi GLg014O+ 11•Cov`\ .. <br /> 7j <br /> Address , � S00� ' p .1 City/State/Zip (� ± c2tt� - <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 /> CONTRACTOR Se11f/L i✓ 61/ ,QP# .gfol/'t1 frAi State Lie.# Se4 -b4 S 82 C City Bus. Lic.# <br /> ^`— (Phone/Email krAV/.-b ,i///..594(h)/1/..--S ci���`L, <br /> Address �'�.j- (301.5 �;• �C? �'� C-y "'� / `mak. !Ig'�� <br /> $ CONTACT FOR PERMITIv eLa <br /> �" i55l( se-KA Ave, v..i A.f; wA4 eno2G <br /> Maher Jera%e&6-�)vvc.'1) ,e0,tn ,}Phone/E-mail Ilt 504, tib a G He , cf <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 1,59/ e7L/e& W4 <br /> Existing Use of Building_U CiLat.v\k -i9JS-eHEAT SOURCE: - - <br /> Proposed Use o = ,•• - Gas_ Electric Other <br /> Building ty'e: Single Family._.Duplex Townhouse _Multi-Family Commercial <br /> Type of proje . New Addition _Remodel —Repair . T.1.T.1. Sign Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> /(i Etti $F - TT, / 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(#)offfxturesShow Number(#)of fixtures <br /> NC-air handling units Toilet . <br /> . Forced air systems I Bathtub - <br /> Gas piping 4. Lavatory(wash basin). <br /> I Water heater. ( I Shower <br /> ' Gas fireplace ( Kitchen sink&disposal <br /> Gas range . 1 Dishwasher <br /> I Clothes dryer t Clothes washer <br /> Range hoodWater heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> J Backflow preventer(inside bldg)Heat pump • - - <br /> Unit heater Urinal <br /> J BoilerJ Drinking Fountain <br /> { Refrigeration Floor drain • <br /> Woodstove J Grease trap <br /> Ducting I Roof drains <br /> Other Medical Gas <br /> • <br /> SPRINKLER /SUPPRESSION SYSTEM • <br /> Other: <br /> Number of Heads I Other: .. . <br /> I herepy certifythat 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 /> Owner/Author -.-Agent Signature Date (Revised 4/2015) <br />