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PERI`, IIT /PPM (ATIOr; <br /> UILDINGrECHA'ACAL/ILMI BIND/SIGN/SPRIT .LEriVDE OLI` IO <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> _llarf: /3 of I'S _ <br /> SITEADDRESS, , PROPERTY TAX# pFPMITit <br /> OOH 2.017/0Z•700 ,- 1 <br /> • <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) ' <br /> OWNER IA Y Iw'-rCt <br /> + Ku t �Gr Phone/E-mail kuici.c -a,e koTYYIp 11. 'off <br /> Address '2� '"` T L/i � T .7 13.. City/State/Zip (�)(`P-,rG t f�t`y 9162,its <br /> APPLICANT: Owner 6/Owner's Agent Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work in the space) <br /> L <br /> CONTRACTOR 56:4Y/Lt '66A-'PP// T IJol m7fo'v( State Lie,# . eke-04 S S2 e- City Bus. tic.# <br /> 7� "� Phone/Email� r / 6 SDS ff��n 5 a�Mfj' <br /> Address ao r f - 1;' Se #'A C-�/ t14 k �Jra I - -.r/ <br /> 1 . 1 :1 1 r i 7 CONTACT FOR PERMIT^� I� IN <br /> 0(v\�+" jF'iolA <br /> 15516 S6`61 4 . V) ca wLaJ 'l: WA- WW tiZG <br /> Maher-tCI ,- & v -i) ,C.0%,i/\ Phone/E-mail It 56 , tiev 1 -H Z.. , r., _' <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 11591 e7el.eCt- hf401 <br /> Existing Use of Building \I ae .v`ik rkkgJS-e HEAT SOURCE: <br /> Proposed Use o n . - Gas_ Electric Other <br /> Building ty•-: g.Single Family —Duplex Townhouse _Multi-Family _Commercial <br /> Type of proje . _ lew ,__Addition _Remodel —Repair—T.I._Sign Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): • <br /> Ai $ ,< - f4-TT jf-f� <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 "3 Toilet <br /> • Forced air systems I I Bathtub <br /> Gas piping 4. Leyafory(wash basin). <br /> I I Water heater. i 1 Shower <br /> Gas fireplace { Kitchen sink 8&disposal - <br /> Gas range . ( • Dishwasher - <br /> i Clothes dryer t Clothes washer <br /> ' tF ! Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> I Heat pump <br /> Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> I Boiler . Drinking Fountain <br /> { Refrigeration . Floor drain - <br /> • <br /> I Woodstove Grease trap <br /> J Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER /SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby 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 ge1c , <br /> application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> _'•- ' ' � �— 71 <br /> iwner/Author'-- 'Agent Signature Date (Revised 4/2015) <br /> itir"")-- <br /> may. <br />