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re <br /> i <br /> r <br /> PERMIT APPLICATION D <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/D=EM©LITI <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St, Everett,WA 98201 425.257-8810 FAX 425-257-8857 www.everettwa.©rg <br /> SITE ADDRESS: PR9PERTYT X PERMIT# <br /> Uvvtr 8 -'...,e2020 ympi 1' `e,/. „f" i Z �/il r7© . , ,, I <br /> LEGAL.for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER PEvitv 4 5IW A i-}ARSTA-9 Phone/E-mall (WSJ 2 - 2 /333 <br /> Address 40, 3353 City/State/Zip et/i5/4"lr Ce/A- 9e Z/9 <br /> APPLICANT: )CC Owner _Owners Agent _Contractor _Contractor's Agent _Tenant(moos provide a letter or consent from the owner to do work in the space) <br /> sc.J[ <br /> CONTRACTOR vNe-g State Lic.# City Bus.Lic.# <br /> Address Phone/EmalI <br /> TENANT BUSINESS NAME' Cc$N'TACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION. CONTRACT PRICE OF WORK -or <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building GasElectric Other <br /> Building type: Single Family Duplex_ Townhouse _Multi-Family Commercial <br /> Type of project: —New k Addition _Remodel Repair T.I. Sign Sprinkler•__Demolition^.Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): 400/new 71 m,,,,r - 6 2, <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project; _Newg_Addn Alteration_Repair Type of Project _New Addn Alteration Repair <br /> Show Number(#)of fixtures Show Number(5)of fixtures <br /> A/C–air handling units Toilet <br /> Forced air systems t Bathtub <br /> Gas piping ,. 'Lavatory(wash basin) <br /> i Water heater I Shower <br /> Gas fireplace 1 Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> • <br /> Range hood <br /> I,. Exhaust fan Sink(service/bar/mop/etc.) <br /> I Heat pump ' ' Backflow preventer <br /> 1 Unit heater Urinal <br /> Boiler I Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove : Grease trap . <br /> Ducting Roof drains <br /> Other _ Medical Gas <br /> SPRINKLER SUPPRES= ION SYSTEM I Other. <br /> Number of Heads J Other: <br /> I hereby certify.that I hays 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. =granting of a permit does not presume to give authority to Ytotate or cancel the provision of any other state or local law regulating construction.,.:� '\ <br /> That I am authori by the own,. of Is property to perform the work for which application is made end I comply with the State Contractors Law 18.27 RCW and 298.2005 WAC. , j. <br /> j` lj•--- <br /> i,,, <br /> �� t <br /> ner/AcTfiorized ,.ent gna re /pate • (Revised 312013) • <br />