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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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: tSOc rw•4 tut a cri PROPERTY TAX# T# <br /> 3003w. CA--Aram . f'casrr-. 40"/1fini o c5-0627. <br /> LEGAL for new construction: Short Plat/subdivision _ Lot No. (attach copy of long legal description) <br /> OWNER YUl f N (,t Phone/E-mail <br /> Address 3e,0 3 c-i, (.*sew° Prz, City/State/Zip I vcner7- &'A- '782.03 <br /> APPLICANT:_Owner _Owner's Agent -A.Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 6g r rays F a R Y SN 0. L&I Lic.# (COE bus.Lic.# <br /> 190 Fe�xnroALr ~ c. R2�8 ( J 7j3Go�„ 3GG - ;¢G"pc <br /> Address Phone/Email 3(�Q' (-1( � 33 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �c J Sve. <br /> Phone/E-mail (34o0 y cJ —-tl S-3 3 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK/ 1,S)0, 00 <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 provided on the back): <br /> PC G./ V r t L t r-y T c-ry nJ t.' 4 Sr£.4 wk PIP/"/C4 LU r'`J t f ti QS--O 3 4- <br /> IK.t5't-rw srF.4on VAvc.-r ' F <br /> • <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: 4New 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 I Bathtub <br /> Gas piping I Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace I Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood I Water heater <br /> • Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler I Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting I Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM J 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 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 /> That I am authorized by the wner of this property to perform the work for which application is made and.l comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> _ . . . P/011401 \\ <br />