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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <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# <br /> . # <br /> 31T- MA <br /> LAP A Pt ill- <br /> ford new <br /> ion: Short Plats . . . Lot No. <attach copy of deer) <br /> OWNER #.+ LA 4L E Phone/E-mail 4Z5 '344 » isjos <br /> Address City/State/zip <br /> APPLICANT: Owner —Owner's Agent OContractor —Contractor's Agent Tenant(mast proviae a tette consent from the owner to dons In rhe space) <br /> CONTRACTOR 1WilebrAfSpit S11007,10 State Lie.# 6eititgeti City Bus.Lic.# 053 ei3CO <br /> Address 74'O/ , /P f/ Agtviz.t' f227 Phone/Emair 6( el/ 012 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> ,fir <br /> Phone/E-mail � A+£/t/. t 5a!l4l/. d <br /> BUILINNG PERMIT APPLICATION CONTRACT PRICE OF WORK j 491 <br /> Existing Use of Building <br /> HEAT SOURCE: <br /> Proposed Use of Building GasElectric .. Other <br /> Building type: Single Family Duplex_ Townhouse Multi-Family _Commercial <br /> Type of project —New _Addition —Remodel k Repair Ti. Sign .,Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional provided back): <br /> grer <br /> ow-re_ 447 <br /> al <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project; New Addn Afferation Repair Type of Project _New_Addn Atteratton Rehr <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C–air handling units Toilet <br /> Forced air systems L Bathtub <br /> Gas piping Lavatory(washbasin) <br /> I Water heater _ i Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer 3 Clothes washer <br /> ( Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heatyurnp Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Waodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER I 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 AA provisions of laws and ordinances governing this type otwo k wilt 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 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 1827 RCW and 298:200A WAC. <br /> T A , ,4 / , , . *ie <br /> Owner/Authorized Agent Signature Date (Revised 912014) • <br />