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PERMIT APPLICATIO14 <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 r www.everettwa.org <br /> SITE ADDRESS; PROPERTY TAX# `PERMIT# <br /> LEGAL for new construction; Short Plat/subdivision Lot No. (attach copy of[brig legal description) <br /> OWNER LAGO De N-ATA V I LLA L.ZPhone/E-mail <br /> .0- W16- �i�s' <br /> Address 6.-X) I lath ST.S2---Orr—nci= city/state/zip EvE�cTr w.4 <br /> APPLICANT:_Owner _Owner's Agent _Contractor —Contractors Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> T <br /> CONTRACTOR CARR NCO CON T VC,TION State Lic.# C.4-i4RGOossvQ City Rus. Lic.# 7 <br /> �? <br /> Address RO50 ,?I Sf/4ve. Si SFATTLE 98144- Phone/Email C,C�A,4R�.uCe�G -COW <br /> CONTACT FOR PERMIT <br /> GE-ORr dO6 5'�-? 660/ <br /> Phone/E-mail CAeCAA kAiV C0P G6A-14. <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK '-5 O©. <br /> Existing Use of Building � U ,O h tw"! HEAT SOURCE: <br /> Proposed Use of Building cSIAG-UF F1iWA;L YIAidU,29GTU/zE0 hWyle Gas_ Electric Other <br /> Building type: X,Single Family _Duplex_Townhouse _Multi-Family ^Commercial <br /> Type of project: _New _Addition —Remodel _Repair—T.I._.Sign_Sprinkler_Demolition_Change of Use <br /> /5W10a' /fCYlJ'F cviT,6i <br /> DESCRIPTION OF WORK(additional space provided on the back): /QFiQQRC�' yIVI'4AX"19CTIJRE� <br /> y,�LU �a?D/sJ /c��?s ..� �JA�f/UF�GTuIPEiO h`dME. .vECU f/ .s��s <br /> .rET yEu/ s->1o�.�- C��rf� rsiTE,pO�LT F{�7NT sT�'/t/Y�O �PElgR �X�T�,(l.Oi/t/6 ul/Tfs`S7� <br /> cTirlT�6 Talmo ioT I�Li ft/,O I`fi4/?�i <br /> MECHANICAL PERMIT APPLICATION 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 /> 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 IWater heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I 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 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 owner of this roperty 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 /> -ea MR) ori ed Agen ignature <br /> ��— / Date (Revised 4/20.15) <br /> 2 <br /> 1 <br />