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. c136250 66„6441: ��V/// t ,& t <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 /> SZ(Y/' n � 2104/ Iao AX# I I Ri' 1 --014 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> r <br /> OWNER 5 C Phone/E-mail Mt,-Z .�'3 <br /> CO <br /> Addressp h91,44 -7 ,•'S I Dot City/State/Zi d X tel!J!Q a oZci <br /> APPLICANT: Owner _Owner's Agent •oContractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR Vi / .S State Lic.4i0LIMP13 ity Bus.Lic.+C ,23 <br /> Addres4 Sb SI Ph3E2a'r <br /> At.S [ - � ICS.Afy <br /> i <br /> TENANT BU INESS NAME CONTACIR PERMITL1(?.e.i.)ebite MU01)114/Art- A / idIK.. Phone/E-mail Atilial4C14"t,lV ^ / e) <br /> CONTRAC �4 �1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WOR /ObpOQ. <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 p vided on the back):� �CJ!-V�� �.7/� az-4-,h, �C(.,lf6 <br /> tett..." -k-f4"-P4-PaiumjcI) ..-tu -o tits, assadJufk� "40iIy" 144 • <br /> ' ' ' <br /> MECHANICAL <br /> PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn 0 Alteration_Repair Type of Project: _New_Addn Alteration_Repair <br /> t Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC—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 comp) <br /> � , i er specifi erein or not.The granting.f a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> T -�thorized 3y h=U r of this prope t perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br /> too <br /> Owner 'u orized Agent Signature Date (Revised 9/201 ) <br /> �`I <br />