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a <br />! <br />ERMIT APPLICATIO <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 />TE ADDRESS: PROPERTY TAX # P T# ` �� �,) <br />. W <br />�Ob `�u �:�: .. � v� 29 o S'3 00o z.00 00 ' <br />LEGAL for new construction: Short Plat/subdivision <br />OWNER ����� ; <br />��G�� �2}Ul L � n <br />� <br />PLICANT: _ Owner <br />Se�v� <br />��� Sul�% 90�� <br />_ Owner's Agent �Contractor <br />CONTRACTOR 1�a -�t� . <br />Address 'Z'j Q-� � pTH �q v <br />TENANT BUSINESS NAME <br />drt F; <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail <br />ICity/Slate/Zip �c n� o� � vVA' 9 fj0 r% <br />COf7�faClOf'S A9ef1� _ TEf18f1� (must provide a leller of consent from Ihe owner lo do work in the space) <br />`�rb v; d e✓+ c t�<9; n,I �cd. C{ r. Gl�: �rtn S i� �+ <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building <br />Proposed Use of Building <br />L&ILic.# <br />COE Bus. Lic. # 0 Zti <br />IPhone/Email Zs3•3??•L2?Z m.cf�-���a-}r; �c <br />CONTACT FOR PERMIT <br />ZS�-3'77-ZLT"Z <br />Phone/E-mail ,...� K-{{—���..-�-rca��'r� . corr <br />CONTRACT PRICE OF WORK �� g 8 d <br />HEAT SOURCE: <br />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 />A!%D �i�i/q���7 T ��O!` i n/!/f' �'s r'o/' AIKf /..,�. •VZ !/ tn�/ G�./.� q S <br />✓ <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of �xtures <br />A/C - air handling units <br />' Forced air systems <br />' Gas piping <br />W ater heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />' Exhaustfan <br />Heat pump <br />: Unit heater <br />Boiler <br />Woodstove <br />Ducting <br />' Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />3 / Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of Fxtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin <br />Shower <br />Kitchen sink & dispos <br />Dishwasher <br />Clothes washer <br />W ater heater <br />Sink (service/bar/moF <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />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 property to perform the work for which application is made and I comply with the State Contraciors Law 18.27 RCW and 296.200A WAC. <br />��� <br />� S � <br />Owner/Authoriz d Agent Signature Date (Revised 6/2012) <br />