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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: i1.AtL /O. PROPERTY TAX# PERMIT* <br /> 3003 w. CASiiLO Lb E.vaRtti 8U* 4C-X40 t3DCQ -D3/0 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER kleAS Phone/E-mail <br /> Address Pb(3o1. 31 b'1 M Is DH-13 City/State/Zip 5 CTL.E% WA 41S12.4- 2.101 <br /> APPLICANT:A.Owner _Owner's Agent _Contractor _Contractor's Agent `Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR SICAM S KA (State Lic.# sI<At IS t SIS RI-City Bus.Lia# <br /> Address (Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT • <br /> SEPF DR 4C.R. *IS-23g—otK% <br /> Phone/E-mail JEFFERY.G. DRkYi6.K # BoELN&. COM <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 340'O66 <br /> Existing Use of Building II F6 HEAT SOURCE: <br /> Proposed Use of Building h i✓G Gas_ Electric Other <br /> Building type: _Single Family _Duplex Townhouse _Multi-Family X Commercial <br /> Type of project: _New _Addition _Remodel _Repair T.I._Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> ZELCCDr1 Ac-&40 ?RAIL PAIL At.L .L ill .111-1, 4T-02. BUil a i 111C- <br /> ZDEIi.31 EVVA(T FLt&I'ru .(wi$I5- q1) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Addn Alteration Repair Type of Project: _New_Addn _Alteration Repair <br /> Show <br /> Show Number(#)of fixtures Show Number(#)of fixtures • <br /> NC—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> 1 Gas fireplace <br /> Gas range Kitchen sink&disposal <br /> Dishwasher <br /> Clothes dryer 1 Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain • <br /> 1 Woodstove <br /> Ducting Grease trap <br /> Roof drains <br /> I Other I Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM 1 Other: <br /> Number of Heads I 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. n <br /> ...„ <br /> 6A7/26P <br /> Ow A h rized Agent ighature Date (Revised 3/20 <br />