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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: PROPERTY TAX# PERMIT# <br /> Zr, 1 fir .() t\—x t i 60q5-7911226 1A-7)I /5)80g"*OR <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER KQ kliegf nj rck(;t/-P.t4 , Phone/E-mail �/yj�j", 1Z3 -- loe'O <br /> Address Zo 3/ 2 ( Jt, P t-f �I P 1/ /3. � City/State/Zip v..O i4-l WP kcra <br /> APPLICANT:_Owner,Owner's Agent _Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR rAt j (; ___.1a State Lic.# 3l 4. Q f)utity Bus. Liic.#S75-G[1 <br /> Address 18 {3 O '( (r i o ( yr,Cv'-Q, O4 70/0 Phone/Email / 615 A 7 17 1 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 1 _ r 'Ci- t <br /> CA— <br /> Phone/E-mail Kt)rie rAiNk C Odd <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE'A iv <br /> I y,/y3.. ( <br /> Existing Use of Building _ HEAT SOURCE: <br /> Proposed Use of Building _ Gas_ Electric_ Other <br /> Building type: _Single Family _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 /> i VN XMA ).') 2ocwtj�c l�-2�i � rf;€)r5 Vo 54-eLL <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> 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 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 compl <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 /> Own /Aut on d Agent Signature !� Ci <br /> (Revised 9/2014) <br />