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'E MI°T A.PPLICATI <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/ P INKLER/DEM LITION <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: ( ( • PROPERTY TAX# PERMIT <br /> : 3• t hAUJa- act r/ _,. ,,r2-f7°3 e3/�3-320ca 0 -, '`' , 0'1114 <br /> LEGAL for new construction:_j_ Short Plat/subdivision Lot No. i !r1(attachh copy of long legal description) <br /> OWNER IN'Nikrk.%l V,..0' tj��1 Phone/E-mail K UL Y1414, jl 6. /Jc3 Gu l ,62 VIA <br /> Address 11,0 S )34'114 51-, SE 94- i ire , c/32O ' City/State/Zip <br /> APPLICANT: OwnerOwner's Agent ^Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTORS 6 RE d 6✓LtLeyi5 (7 077,1-ndN GLC State Lic.# .5641-71-1 ))4282c1----City Bus. Lic.# <br /> Address �,1 /30a c ' c 4 , /; ,� Cc/4 48'�f Phone/Email i ii(`P-/6# // '5 bibliafia e3ArftL <br /> TENANT BUSINESS NAME j I CONTACT^�FOR PERMIT i <br /> \ - ut.k <br /> z4_ 5---__s-,,i-6444 ., Phone/E-mail aj .5-6/1-40 ir Oic3 6414-7 L , Ga 1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building A/7 i, HEAT SOURCE: <br /> Proposed Use of Building. Wiz/ , __ GasElectric 9✓. <br /> _ - Other_ <br /> Building typ Single Family _Duplex^Townhouse 1. A. i ommercial <br /> i I 1'4 Ali 1 KS' <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 /> N0A) s . - 1-7-,, ED <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _lew_Addn _Alteration_Repair Type of Project: jNew Addn Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C-air handling units 3 Toilet <br /> Forced air systems j Bathtub <br /> Gas piping 4 Lavatory(wash basin). <br /> I Water heater I 1 Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> Gas range ( Dishwasher <br /> I Clothes dryer I Clothes washer <br /> 1 Range hood Water heater <br /> 4- Exhaust fan I Sink(service/bar/mop/etc.) . <br /> 1_ Heat pumpL Backflow preventer(inside bldg) <br /> Unit heater f Urinal <br /> t Boiler j Drinking Fountain <br /> Refrigeration Floor drain <br /> ( Woodstove 1 Grease trap <br /> I Ducting I Roof drains <br /> 1 Other Medical Gas <br /> SPRINKLER /SUPPRESSION SYSTEM Other: <br /> • <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 propertyto perform the work for which ap lication is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> `��'� s //kr <br /> 9 <br /> . <br /> Owner/ uthorized Agent Signature te (Revised 4/2 2 <br />