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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 if PERMIT** <br /> LEGAL for new construction: Short Plat/subdivision Lot No. , (attach copy of long legal description) <br /> OWNER O """'t y'-x( PhoneIE•mala 41.5-` t)t~w'1 3& <br /> Address 34x03 y..J. Cir.rS t sJO tor' . City/State/Zip 1\1 Gr -tw"1 T w A. `.8 203 <br /> APPLICANT: Owner 4 Owners Agent Contractor Contractor's Agent _Tenant(must parade o Naer of consent from the owner to do work In the apace) <br /> , <br /> CONTRACTOR, f-I-'t State Lic.#INC,P MGG t to' 'tJC...City Bus.Lic.# <br /> Address '"caca"2j Vim. t St'O C2-1 . Phone/Email la.)(.' 44411" <br /> TENANT BUSINESS NAME CONTACT'FOR PERMIT 3 t K <br /> Phone/E-mail 4 30t-2585 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building C)ttC..E' HEAT SOURCE: <br /> Proposed Use of Building NCA. Gas_ Electric_ Other <br /> Budding type: Single Family Duplex_..,__Townhouse __MuRb•Famity Commercial <br /> T •e of prosect New Addition Remodel Re.air Ti._ Si.nSprinkler _aernolition Change of Use <br /> DESCRIPTION OF WORK odd/lanai space provided on the back): <br /> t2, --y-haat-,..t-10,5 r..a /12.,c-1-4yr t.,. v,r ?e t Vrt.►a<a i3ue.t,."t..:tO t,j tet <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn Alteration_Repair Typo of Project: ___New,_Addn _,Alteration_Repair <br /> Show Number(#)of fixtures Show Number 00 of fixtures <br /> NC-air han•I ng units I Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater i r Shower <br /> ,. „., Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher _ <br /> Clothes dryer I. Clothes washer . :,. ..., <br /> Range hood Water heater <br /> Exhaust fan , Sink(service/bar/mop/etc. <br /> Heat pump Backflow•reventer <br /> Unit heater Urinal <br /> Bober a n ng ountatn_s, <br /> Re r eratiotl <br /> �, � Floor drain . <br /> Woo stove Grease trap . <br /> tom_. *� Roofdrains <br /> t <br /> Other i Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM 1 Other, <br /> Number of Heads I Other. <br /> I hereby certify that I have reed and examined this application and know the same to be Into and correct.All provisions of laws and ordinances govern€ng this type of work will be complied <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 /> Thal I am authorized by the owner of this property to perforin the work for which application is made end I comply with the State Contractors Law 18 27 RCW end 298 200A WAC <br /> A.---- A?)..../.........,„,.:,_ <br /> -,..„.,I 9,--). e5714-ki„ <br /> Owner1Aut6ortzed Agent Signature D (Revised 3/2013) <br />