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ilk <br /> llk <br /> ER.MIT APPLICATI <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: L I n I PROPERTY TAX# PERMIT* . <br /> '. i- .uta- {\ate -` , a's7,03 .0,03 -32.00 0 ./i0 G3 l2•--0 o <br /> LEGAL for new construction: Short Plat/subdivision Lot No. �Fl(attach copy offllong legal description) <br /> OWNER {r\ tj0..\ J et4 Phone/E-mail K(JL 4 .-ple f c3T Di.i!\ cavo, <br /> Address I2PS 134- 5),-, SE 9`4- C' ; 83208' City/State/Zip <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 5 erf Z ar c.OJ0iY /' crf, -? v aC-State Lic.#.5E- }-T f D 4`8 ZC i'" City Bus. Lica# <br /> Address /24.1 0Phone/Email Z17-P/—6#11 '5 44-Ifi2// 'i <br /> TENANT BUSINESS NAME � 4-1 C��� �� ��ONT�FOR PERMIT � � ��'7 gcc <br /> 4S- 1- 44l . Phone/E-mail ....1) ��1/k' lY 0S. ) 611*1 G I Co '1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OFFWORK _® . _ ' <br /> Existing Use of Building V7 HEAT SOURCE: <br /> Proposed Use of Buiidin• nor •-- •. ' . Gas Electric V7Other_ <br /> Building typ•: Single Family _Duplex_ ownhousehl,ww..4��r ommercial <br /> Type of project: /New _Addition _Remodel _Repair . ._ Ign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Nit (S —f-- i ILD <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: ew_Addn _Alteration_Repair Type of Project: j. New Addn Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C air handling units 3 I Toilet <br /> Forced air systems j Bathtub <br /> Gas pipingL. Lavatory(wash basin) <br /> 1 ` ( Water heater { I Shower <br /> I Gas fireplace 1 Kitchen sink&disposal <br /> Gas range . ( Dishwasher ' <br /> I Clothes dryer � Clothes washer <br /> 1 I Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) :. <br /> • <br /> — Heat pump L Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> 1 Boiler I Drinking Fountain <br /> I Refrigeration Floor drain <br /> Woodstove I Grease trap <br /> 1 Ducting I Roof drains ' <br /> I 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 auth ri ed by the owner of this property to performs,,,,,_the work for which ap lication is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> i,„4„., <br /> Owner/Authorized Agent Signature /Date (Revised 4/201;),,,-,,, <br /> • I <br />