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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:�19-j '= PROPERTY Tex# PE T <br /> - 'v is Zg �-i 1' 13v�?�taQ I (� <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER��If r'�(>�J���_�.1 Ct —30 Phone/E-mail <br /> Address t',,I QEi����� ��-�5� City/State/Zip <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 L&I Lic.#Sj^i�/�� COE Bus.Lic.#CD-I I 6-0�:3 <br /> Address �� ��t�U r.i y�j J/JG�{0► l.Jf3ZqC,, Phone/Email,5 ir--iJ. —FI <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> ..c���/1��, � �IFt cis T''� �w►t 1-`� I:�e._->✓ <br /> 9Ci3G 3 +� 4,.i <br /> Phone/E-mail 14457 i'-i <br /> �Ml��r�ti► <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building C moi &-- • J HEAT SOURCE: <br /> Proposed Use of Building <�iFFit_dE- -5F'Ae- Gas_ Electric Other <br /> Building type: _Single Family _Duplex Townhouse _Multi-Family K-Commercial <br /> Type ofproject: New Addition Remodel Repair T.I_ Sin AS rinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> 1�s�1,Q �xl.S 1 1�� Fi(Z�-��1�K�..� �(�t]Cs►t ot9'.��-M Ri>-!d� �F <br /> LIA- <br /> SP91 r-1 VI-'L M�E4C�i, Rz.3 13-A i•4-, �}CZ.��'}ao .�v i TSS 1 C'o C>573 4-- <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 /> Refri eration 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 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 stale or local law regulating construction <br /> That I am authorized by the owner o 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 /> Ow !Authorized Agent Signature Date (Revised 6/D <br />