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• <br />i <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 />SITE ADDRESS: � :7 •"� `� PROPERTY TAX # P MIT # <br />2���� ����%�s��� � � � _�;� �. <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER _.���ai(��'/91'�f',-r/%%��"�/?�f t�/Yl(f' �one/E-mail �`��a.__<:�°��C�� '"��/tc�i2���l�:�''� <br />-.:, . <br />� , .� --^' f <br />Address ��( ��� l.�•��.""S/ �L�`—i� � Y p ���� �� �� � ,�'� c"'� � t� 1 <br />Cit /State/Zi ,�' � ' r <br />APPLICANT: 4! Owner _ Owner�S A9211t _ C011tfaCfOf _ COf1lf8ClOf�S A9811t _ T0f12111 (musf provide a letter of consent from the owner to do work in the space) <br />ONTRACTOR <br />TENANT BUSINESS NAME <br />� - ��I �.;� <br />BUILDING PERMIT APPLICATION <br />State Lic. # <br />�Phone/Email <br />"ONTACT FOR PERMIT ?'� <br />.���� .. rt'7t �� r�2� <br />�� � <br />�hone/E-mail f1 ix/�(X�6�' <br />r <br />�ONTRACT PRICE OF WORK <br />City Bus. Lic. # <br />� •�11,r4�!!"�'•c % <br />, <br />E�'�4' �G�/�'lCl� � C'G`e�i) <br />. -r , <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas_ Electric t� Other_ <br />Building type: Single Family _ Duplex _Townhouse `� Multi-Family _ Commercial <br />Type of project: New _ Addition � Remodel �tRepair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): <br />f� �: � ��f <�� �'�c �:�,s � ;�� � �"r l c..:K�'--.,�" � ���-%,�r"�s�=�'� � �i�",�� L.r.�i�=,��'r���c�� <br />�,� �c� ��c� �. f� �.,� � C"�,��?..��- % `� ���������-�%� �c�' �� ����'Y'k <br />„ <br />, � � <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />A/C — air handling units <br />i Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />! Woodstove <br />Ducting <br />j Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />j Toilet <br />; Bathtub <br />I Lavatorv (wash basin) <br />Snower <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 />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 gra ing 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 lhe owner of this pr�rty lo perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />�--� <br />/ � �� ` �, � � ' ' i , �,�'/ < <br />,C� , �� . � "` - - � c; �=` � <br />� (Revised 3/2013) <br />Signature <br />