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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 ADDREW FLIt3j LIP ROPERTY TAX# P RMIT# <br /> S .S bO' 15/16W CASINO EUELEIT 6 I a rs 01-bb <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Bbl N,& Phone/E-mail <br /> Address PO Mat 3101 11 IS 1.)17%-1 City/State/Zip 5"£1`Pf L1 , WA 'ass-220 7 <br /> APPLICANT: ) Owner Owner's Agent _Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work In the space) <br /> CONTRACTOR SCNUClfi 1- State Lic.# SClIUCC*I ) N C City Bus. Lic.# 4zo411 <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> 36K DP A`f ElLd 4 5-2.313-'0111 <br /> Phone/E-mail x,Es.,1• G D1 A'deL. bow 1J6•&8 M <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4- ,-cue 11 Sc'c) <br /> Existing Use of Building MFG HEAT SOURCE: <br /> Proposed Use of Building M FCC 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 /> .1-1-15111U-11170 N o!- <br /> 4 ) 772/9/WI °,u � Fc/6/�1"UNrz, �/�- tuv�id�/ 45-�'00� <br /> O! 67, $S o <br /> P""'� Yeo 0611 LCL site-c <br /> ME ANIC PERMIT PPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> I A/C—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 i Drinking Fountain <br /> Refrigeration- <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 complied <br /> with whether specified herein or not.The granting of a permit does not presume ta give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I 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 18.27 RCW and 296.200A WAC. <br /> fr# //SAO/5-- <br /> Owner/Authorized Agent Slgrature Date <br /> (Revised 3/2093) <br />