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o <br /> 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# P RMIT <br /> S t 35 S t.t,-D ��E' tic tQ�coo 2L) o t� Ui l t— O�� <br /> LEGAL for new construction: Short Plat/subdivision ` ' (( Lot No. (attach copy of long legal description) <br /> OWNER AN-r 4 Vt2.151 M.4�,41 Phone/E-mail X2..5.21 .4,c x"� s'74r)c)r}�1C"'' n,($r,'.L,�it„ <br /> Address 13�� 5c 1,.417 �0" City/State/Zip i4 l�z-13-C+C- in..)A 1- 1' <br /> APPLICANT:4„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 ,\ �(Z._ State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT--c—c•4...1 �t <br /> Phone/E-mail U L .2„1$41 o tpq m c 12.e *14 /bJ 4.(91.00 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK_ C32-.)(X`ip- mac — <br /> Existing Use of Building 4 Y - HEAT SOURCE: <br /> Proposed Use of Building 61t/tU•6 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):' yern 1y� ©� ins _ Gx n,st3 <br /> wt►�G �R� <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 f(Yu-uArt. I fNLvKGNh 2. Lavatory(wash basin) <br /> Water heater / Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer t Clothes washer <br /> Range hood 1 Water heater <br /> Exhaust fan • Z. Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler ' Drinking Fountain <br /> Refrigeration 1 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 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 /> Z <br /> Owner/Autho ' ed Agent Signatu a ate (Revised 3/2093) <br />