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isER \T /ADPL CATIS.�. <br /> • ' ' CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St, Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> -6(0 - /4 of IS <br /> SITE ADDRESS: 'n PROPERTY TAH# PFIRMIT <br /> - . r ,tet Oo3 2vofoZ7ao C'ef510-0J -- <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copyy of long legal description) <br /> OWNER .n Ylityjlek-e+ KO lG�%. Phone/E-mail KV lc,, 1—G l 14o`)'w ai i 1.co <br /> Address l`Zo c R 1J l�. S A. �jr 4 0 r City/State/Zip c �/"G- j-. )4 2 tos <br /> APPLICANT: Owner '/Owner's Agent Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp worts In The space) <br /> CONTRACTOR s6'4%56:4r77.t' 66/074 Pli ' ,°"'77/DA'te.0(State Lie.# s-ekr- 4'g' f City Bus. Lie.# <br /> Address r2c7.T (30 - r...;-, Se #'A L� `�JC'/ 14-vPhone/Email kr/0i•-6 4/C//JSDhrh11tS ,,„7,49,, <br /> •II t I r 7 CONTACT FOR PERMIT- --mckker-weL0452- <br /> ,-I 1S%t6 56`6 fivesvv .8.4.A.0,,,14,-, w %gozG <br /> M IherliklA..• 60onaL.'() ,,Cc��in . .Phone/E-mail.fat SU . pie.< 7 -h+ 1- , r o • <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK i, '74.01. lW d of <br /> Existing Use of Building_V e(G'e+.v\k- .9J3-e HEAT 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.l._Sign_SprinklernCh <br /> _Demolitioange of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <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 7 Toilet . <br /> Forced air systems J I Bathtub <br /> Gas piping4.. Lavatory(wash basin). <br /> I Water heater. ( I Shower <br /> Gas fireplace ( Kitchen sink&disposal <br /> Gas range ( Dishwasher <br /> I Clothes dryer 1 Clothes washer <br /> Range hood Water heater <br /> Exhaust fan ( Sink(service/bar/mop/etc.) <br /> Backflow preventer(inside bldg) <br /> Heat pump • <br /> Unit heater Urinal - - <br /> Boiler •( Drinking Fountain <br /> ( Refrigeration Floor drain . <br /> Woodstove J Grease trap , <br /> Ducting j • Roof drains • • . <br /> ( Other Medical Gas <br /> • <br /> SPRINKLER /SUPPRESSION SYSTEMOther: <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 ibis 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 WAG. <br /> `/7fzr-3/c <br /> iwner/Author'•- Agent Signature Date (Revised 4/2095) <br />