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11111111 <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION‘- CITY OF EVERETT PERMIT SERVICES <br /> .,23200„Cedai.St ,'Everett WA 98201 425-28778810 • FAX 425-257-8857 www.everettt6.org <br /> • 3.3 3 <br /> • SITE ADjaRES,S.', - • --- fr0.510PROPERTY TAX tt'' • <br /> 1 <br /> LEGAL for new constrUCtion:r`ShOrt-plat/subdivision • - • - -- • . Lot No. • • (attach copy of long legal description) <br /> AddressCity/State/Zip2207 <br /> APPLICANT:"jf,„Owner OwnerlsAgent-_- Contractor -• Contractors Agent • Tenant(must provide a letter of°°11can!ficin the owner to do work in the space) <br /> CONTRACTOR, - ' State Lic.# sigystos(1841,25-Kr City Bus.,Lic.# , <br /> Address Phone/Email <br /> TENANT BUSINESS NAME • ' CONTACTFOR PERMIT; • <br /> 45-23 -OI' <br /> . . <br /> - _ Phone/E•-niair-.AE,pff,tyC:G DRA`leiLe- M <br /> BUILDING PERMIT APPLICATION‘--_, CONTRACT PRICE OF WORK -"ft3"/) - • <br /> Existing Use of Building HEAT SOURCE <br /> Proposed Use of Building M P& Gas_ Electnc_ Other <br /> • <br /> Building type Single Family Duplex -1Commercial': <br /> Type of project New Addition Remodel Repair T.I. Sign_Sprinkler_LDetholition_-__Cliange of Use • <br /> DESCRIPTION—OF WORK(pdditionaf space provided on the back) <br /> Rat4609-rieue 0.ot- 7pic4ø-c4:',$ti /,16 47.11 IP,PIALL/14-V‘` <br /> iLøoif <br /> MECHANICAL PERMIT APPLICATION - PLUMBING,PERMIT APPLICATION <br /> Type of Project: _New_Addn Alteration_Repair • Type of Addn _Alteration__Repair <br /> Show Number(#)of fixtures , ' Show Number(#)of fixtures , • <br /> 1- A/C=air handling units I Toilet • , • <br /> 1 Forced air systems . 1 I3athtub <br /> , 1 Gas piping • - Lavatory(wash basin) <br /> 1 Water heater • Shower • <br /> Gas fireplace ' 'Kitchen sink&disposal- • <br /> Gas range Dishwasher <br /> Clothes dryer ,Clothes washer <br /> Range hood - ' ' ' Water heater <br /> • Exhaust fan - • - -Sink(service/bar/mop/etc) • <br /> Heat pump 1 Backflow preventer <br /> Unit heater . Urinal <br /> Boiler - a • Drinking:Fountain . • <br /> Refrigeration • Floor drain. <br /> VVoodstove Grease trap <br /> Ducting - Roof drains <br /> Other - Medical Gas - <br /> SPRINKLER/ SUPPRESSION SYSTEM- Other <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 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 /> • <br /> 1 66 <br /> Owner/•gr ori''e‘'Agent Sign' ure Date (Revised 3/2013) <br /> • <br />