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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 425257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERTY TAX# P I # Lf <br /> "�S J. ..r4,taa cam. tf 0 VOO <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER ttc)t"l*'3Ca Phone/E•mall 41.5— t..2.88 <br /> Address ':c» '\ . twJt) t . City/State/Zip r; s)€ t:"rc,u)A► 913 2.o-3 <br /> (APPLICANT: Owner .24°Meet Agent Contractor —Contractor's Agent Tenant(trust provide a tener of consent from lha Owner to dowork In the space) <br /> CONTRACTOR + (^1.t-4 v'raJ State Lit#13rO I J t C._C 5 b 'JC,City Bus.Lic.# <br /> Address "",00-S '%."--). C.ArbtsJO Phone/Email ' �+-, toad 1 <br /> TENANT'BUSINEbS'NAME CONTACT FR PERMIT <br /> .41tp4t IA�,A3,r <br /> Phone/E-mail 42-6–"3 mat~2-be <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK . <br /> Existing Use of Building '06.-t -L- , HEAT SOURCE: <br /> Proposed Use of Building 1-/744 Gases ElectricOther„ <br /> Building type: Single Family Duplex„Townhouse Multi-Family Commercial <br /> T pa of pro'ect: New Addition _ Remodel __ Repair T.I. Sian Sprinkler *emotitian Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> -1-t.r�t.,.^57‘.•a+ /1z,c-iekAwa&Nt.... of (4.3-t sti)to %u<tO rho C 1 46-st4. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: ,,,New Addn AlterationRepair Typo of Project: New Add,'" _ Alteration Repair <br /> Show Number(#)of fixtures Show Number(5)of fixtures <br /> A/C-air handlinj units I_ Toilet <br /> I Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas'ireplacsKitchen sink&disposal <br /> Gas range ; Dishwasher <br /> Clothes dryer 1' Clothes washer <br /> I Range hood j Water heater <br /> l Exhaust fan l Sink(service/bar/mop/etc.) <br /> Heat pump I Backflow preventer ff <br /> Urinal <br /> I Unit heater - .. ' 1 <br /> f <br /> Boiler j' Drinking Fountain <br /> Refrigeration Floor drain <br /> t Woodstove I Grease trap <br /> Ducting j Roof drains <br /> Other j Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other. <br /> I 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 ordelances governing this type ot work wit be complied <br /> with whether specified herein or not The granting of a permit does not presume lo give authority to violate or cancel the provision of any other stale or local law regulating construction <br /> That lam authorized by the owner of this property to perform the work for which application Is made and I comply with the Stele Contractors Law 15 27 RCW and 29a VOA WAC, <br /> .0, 1,6. lif-iC,t,1-1/4-------------- &//4-iii- <br /> Owner/Authorized Agent Signature . Date (Revised 3/2013) <br />