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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# P MIT r <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER S iEEL Phone/E-mail 2. � -Z <br /> Address City/State/Zip ZL> <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 L t j r State Lic.# -,(1410e.!7City Bus. Lic.# <br /> Address ) / ( ' C� Phone/Email 42'A-ci--6b 37 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> 13aJucc- CA-112-Is <br /> ELY- Phone/E-mail e.hr I� h2►� CC lZ v h(11 t7�c�1 ��m <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building AtrmY�,�,,, nFFI r HEAT SOURCE: <br /> Proposed Use of Building k10 �.mtF7 F- 1-6 u Gas_ Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _)L Commercial <br /> Type of project: New Addition RemodelRepair_T.1._Sign_Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> Rte 04i5'-1V1ff e 1 IJP EXT, F1(,A 5Rer5- I QjFXA J J2-- T*VZ:7 1*c(IZcb-r 1-0�t N <br /> t~RAMIN4- f-Uvv% Z + Q-e; PL.ACC I�E34 IE: -5TVCX-C--,1W 1►JE>0WS <br /> I AL <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 i Bathtub <br /> j Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> j Gas fireplace j Kitchen sink&c1ispg&6l <br /> Gas range Dishwasher <br /> Clothes dry Clothes was r <br /> Range od Water he er <br /> Exh,4dst fan Sink rvice/bar/mop/etc.) <br /> at pump j Ba flow preventer <br /> nit heater Ainal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> j 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 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 /> k,;t::)az� \(21 <br /> Owner/ uthorized Agent Signature Date (Revised 3/2013) <br />