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• <br />• <br />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: PROPERTY TAX # PERMIT # <br />7 C�] P�iL-�rJ �Q,\�l� �JGvr.�-rr' �A�A q �A�il"1/d'f�.?/Y�7 C -, �% � � ` r,�f�� � <br />LEGAL for new construction: Short PlaUsu <br />ER <br />7 <br />No. (attach copy of long legal description) <br />�� � 25• S 13 � 135'3 <br />Address �D� Y�K,s UQavE .�u�Erz�rr W A� �City/State/Zip yVg¢�r� .1NWr �� LOS <br />APPLICANT: _ Owner � OWf1Bf S A9Efli _ COIlff2CtOf _ COIltfBCtOf S Ag0f1S _ TBIlBflt (must provide a let�er of wnsent from the owner to do work in the space) <br />CONTRACTOR T. $. �. L& I Lic. # COE Bus. Lic. # <br />Address Phone/Email <br />TENANT BUSINESS NAME CONT CT FOR PERMIT <br />�PcM�S �'t-wMPcS <br />Phone/E-mail , Z .r <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � �_ <br />Existing Use of Building �� ��f HEAT SOURCE: <br />Proposed Use of Building {� b C,lh,�S�JI�� Gas Electric DC other <br />Building type: ,� Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New � Addition Remodel Repair _ T.I. _ Sign _Sprinkler _Demolition <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />Z�;y= �F/' � -r-.� � l-�✓; .,1T P.��>,-�,. ,�,Prritv� <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas ranpe <br />e <br />eat pump <br />nit heater <br />Woodstove <br />SPRINKLER / SUPPRESSION SYSTEM <br />{ Number of Heads <br />e of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: _New �Addn _Alteratio� _Repair <br />Show Number (#) of fixtures <br />� ! Toilet <br />1 Bathtub <br />Shower <br />Kitchen sink & disp <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <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 />. �� � <br />n <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 authori 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 fo pplication is made and I comply with the Slate Contractors Law 18.27 RCW and 296.200A WAC. <br />� __. <br />. <br />r �- <br />i <br />�� � l <br />' � e vt ize gent Signature , Date (Revised 6/2012) � <br />� vl r/ <br />/� <br />