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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: EVC,tLc'77/ct-5/4- PROPERTY TAX# PERMIT# <br /> 77J1 24/"// �2. '' �� ,a3 15i o —60g <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER E Phone/E-mail dlid 343 //'/S! <br /> Address ,3 D 2C, 6i4 v p L,a4 City/State/Zip y c t� "rJs1 <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 t O/c1 S f'S ic-fr Lc S L&I Lic.#/t/tG/7.5/ts /)t COE Bus. Lic.# <br /> Address '7/0 % i 3 1"` /-'L S C.. Mr CC C �aji4 Phone/Email 4')5-- 3 - 1'/T3 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> AZ.47- L T7 <br /> 8. jZ/ c.L L K .✓ "d!%4J ) 7 Phone/E-mail 4/ —3.53 `// <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK .6 GO <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 T Addition Remodel _Repair_T.I._Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> g c=C j T J1 C l-( E-d- I itrdN- MoPWW e4t <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 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 appication and know the same to be true and correct.All provisions of taws 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 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 /> Owner/Autho' ed Agent Si re <br /> �/2/3ate (Revised 62012) <br />