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� � <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 # P IT <br />, <br />� I �� � IN �1 w��rV� ; ��� �� ��. � J � % � L `'� � � �,� � �� b (� � � <br />LEGAL for new construction: Short PlaUsubdivision <br />OWNER �.�L. ����'L''V Y l � <br />„7 � - <br />Address ^ t � � � `� � G � � t� , <br />APPLICANT: Owner _ Owner's Agent� _ Contractor <br />CONTRACTOR ,� Q,�'�;� � i'��� 4_� <br />Address ` � �Xj �� `��I LlV \�- r �U 1� � \'� <br />TENANT BUSINESS NAME ' <br />BUILD/NG PERM/T APPLICAT/ON <br />Lot No. (attach copy of long legai description) <br />_ � �? _ � � <br />Phone/E-mail � (j �i� � � <br />�. City/State/Zip %���J��;� �`�,� � � (�L <br />_ Contractor�S A9eflt _ T@f18f1f (must provide a letter of consent from the owner to do work in the space) <br />� <br />L & I Lic. # � �' � `,. • ; � COE Bus. Lic. # <br />i , {� �' - <br />���'� � ' J �T�� � �, Phone/Email ��l�J �o '" � � �� _ -y � i �,� <br />CONTACT FOR PElRMIT r �� <br />�-i � 4� `�'- r � <br />r �� �T <br />Phone/E-mail 'a—(j`+4 '- � � _ � � <br />CONTRACT PRICE OF WORK � �%U � <br />Existing Use of Building �`�.F�,,�9 i x� HEAT SOUR E: <br />Proposed Use of �uilding .T ���� t.:� Gas_ Electric r 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 />j,��, <br />�� J ��j„G�v���. ; �,\ �`��� �( � r ��,, -�-� („►v_ti Si..- ( ST�L'� j� �"�_ <br />+� <br />J <br />MECHANICAL PERM/T APPL/CAT/ON <br />of Project: _New _Addn �Alteration _Repair <br />Show Number (#) of fixtures <br />H/t; — air nanaung u <br />Forced air svstems <br />heater <br />Gas range <br />Clothes drye <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />Ducting <br />Other <br />SPR/NKLER / SUPPRESS/ON SYSTEM <br />Number of Heads <br />I hereby certify that I have read and examined this application <br />with whether specifed herein or not. The granting of a permit <br />That I am authorized b e owner f this pr ert to perform <br />f .� -, 1I �.W . � <br />Owner/Authorized Agent <br />PLUMB/NG PERMIT APPLICAT/ON <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />ow �reventer <br />n <br />rioor arain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied <br />; not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />�ork for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />���� �,� I �� <br />Date (Revised 6/2012) <br />