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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# PERMIT# <br /> 'LLt 15— ( ITh F .. .tral r(,)P1 qg��1 ;lot 0514co213lDC. 144 It 07.--00(0 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER 41-311.144e,, AAss o J Li--c-- Phone/E-mail d1 Wtis AulLK...,sh^e fro et 0,5Si C.!LS - <br /> Address U2- o (�'1 p�, ?�D City/State/Zip t1�V�\ iv.) rT 4Q0s- <br /> APPLICANT:_Owner _Owner's Agent XContractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR e-,t✓ve/o q j. LUt/ pitlit 4fiteu,y(S State Lic.#Se lZ\J ES 8 I KD City Bus.Lic.#05226 S <br /> Address (1'>0 jic AR,s (3l SA4Iort.,I,,u•A c(jto O Phone/Email y ZS -'JOQ—5 5I <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> tsh�,w ,.e.... .�55 6atk,k c)t L.L.0 '3e-V-�'` �•1'e+�s�P �-ttS--3 —5515 <br /> , c- d' <br /> Phone/E-mail `}So re.vtS 0 e eS-e. ern`VtettEw ei'( t"t <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 42,00.� <br /> Existing Use of Building v'Vt> t-Pcktnn. 4 pc..4-okev* HEAT SOURCE: <br /> I <br /> Proposed Use of Building i' t 'i Gas_ Electric Other,__^ <br /> Building type: Single Family _Duplex Townhouse Multi-Family X Commercial <br /> Type of project: _New Addition _Remodel X Repair_T.I. Sign Sprinkler_Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Nook-„ p & 4I,� dW. c -S +., tJ(c+4& ,o t' Vevni-s A-- 8” 11 ,4..i (a.w 6�-k,ro 4.•. <br /> cj,,k_pitAAt +E,1� .ttSA V2r�C tom— orst Yens e AtLi4c�s<t�S <br /> X11 DS - 02-e) <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration X 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 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 /> Co 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 /> 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 y the wner 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 /> 2-5--1$ <br /> Owner/A hor A ent Signature Date (Revised 9/2014) <br />