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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 /> Zc s RpcK.ecct.�IZ i -o Z -61" <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Ml4g,e_ T{(A(fl (IJ Phone/E-mail Z06-5/6-25/8 ,t1/4/2/1/4/eC (L�S-COh-)S7iQ0C17611.. C0N1 <br /> Wl 141eySci r of <br /> Address ego 6 041,4AX peio-( �-� City/State/Zip (A)P, <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 1/065 Co&JState Lic. # City Bus. Lic. # <br /> Address r6,06 mel f vE Aj Phone/Email ?_06 5/0 ZS(- <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT /t'tlgr �ctCli I <br /> who EuieJJ C o 7..06 s(c) ZSys <br /> Phone/E-mail 44 a)60-6-S -COO TK() m.o.CQ m <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /c3 op( <br /> Existing Use of Building .22- ./C .//"...6--S/U 441-' HEAT SOURCE: <br /> Proposed Use of Building S !4 4/1 4- Gas Electric} Other <br /> Building type: Single Family Duplex Townhouse 4vlulti-Family >4.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): j;,,yt O A. Cc p / C,pi>v/yx.44/T <br /> )ll 0- A431) 1--i51 1(4 (,)i4 �PA) 4)E�/z <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Adds _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 i Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM i Other: <br /> Number of Heads Other: <br /> I hereby certify that I have read and examined thi 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 gr-• ing of 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• • ow•• . thi •rop 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 /> 1.1a <br /> /C/IL/4.1 <br /> Owne • . • z:. Agent Signature Date (Revised 3/2013) <br />