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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: \tko kko�f PROPERTY TAX# P RMIIJ#I <br /> J Ua 43 gfs 00500 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER A Nps Phone/E-mail 125- '{0( -204 <br /> Address 1106 140Yr A,jE- City/State/Zip EV t I, I$A -t ei.0 <br /> APPLICANT:_Owner XOwner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR OWN - State Lic.# City Bus.Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> SC.,0e a,a <br /> Phone/E-mail 20(p-4771.."!It A(.E4.,�"%GNDa5.V01'1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK `1,1-S,aoo <br /> Existing Use of Building cirg HEAT SOURCE: <br /> Proposed Use of Building Silt- Gas_ Electric X Other_ <br /> Building type: _Single Family X Duplex Townhouse _Multi-Family 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 /> 470-- IN?ff-`O2 TZZ o0 I tem OJM- of t"rf. WAp., <br /> (ZrN10✓e Wb,L. t►a VASE.rt et.-• NE.'") ( pprul-JT <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _LAlteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C-air handling units 1 ; Toilet <br /> Forced air systems 1 _ Bathtub <br /> Gas piping 1 Lavatory(wash basin) <br /> I Water heater Shower <br /> Gas fireplace 1 Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer 1 Clothes washer <br /> i j Range hood <br /> Z 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 /> Woodstove 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 comp <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 au orized..'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 /> A4 / e)/ <br /> Owner/A /orized Agent Signature Date (Revised 9/2014) <br />