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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 />ITEADDREqS,,S: �-�}OC'' EVE': r+}- �,�/� <br />. >> � i:' ! �l� ��":r � � � Lc-t� ( [� �c:;i. �'U':"iy` �f'�u ZG �7 <br />EGAL for new construction: ShoR Plat/subdivision <br />.� <br />ress 1 '� rU �.' �L, �, 1, .•� � <br />'LICANT: _ Owner _ Owner's Agent _ <br />TAX # <br />c <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail �� M c, - �'�" `5 �-' - ' �� � �� <br />City/State/ZiP � f� v� t C n E c w �, ��. , u., r� _ ('"f� � L '� � <br />Contractor � Contractor'S A90flt _ T8f18f1t (must provide a lelter of consent from the owner to do work in the space) <br />��e (;00 3y0z.� � <br />CONTRACTOR �. f, :r f" F' �,,- �� .- s State Lic. # 1. �r-r� ;�� ;.i N o City Bus. Lic. # d;'�-� 3�� <br />'� � Z `� ' ' '� �^ , . �- Z.5 -Z. I D - Z 7 G 7 <br />Address . � l ��� � ,N C �Vi&v ��,, � � �� (i✓� l� �� � L i'CJ Phone/Email �,, 1 rs ��-�i�kt�v�,��: ��,�ss�j , G��:v� <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />��U � 1�<<v �,1 �w�..s�-; <br />� ' \ Phone/E-mail � T' -�'3 Y� ,_ `( �.� Ci �7� 'J,-�a>ts�.. •,;, � u.,-. <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �� � I u � C% �� <br />Existing Use of Building Cc �s,,,,,, �=-c. .� � <br />Proposed Use of Building L c�.�.� r.�, C. :- .: � <br />HEAT SOURCE: <br />Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />T e of pro ect: New Addition Remodel Repair T.I. Si n Sprinkler Demolition Chan e of Use <br />DESCRIPTION OF WORK (additiona� space provided on the back) : <br />� � , I I �{� �. � � i E �-�}- < . . � . �.� � , . .-, r��<, , � -� . �►�ci �us���l y� (� L:L �iC: t � • <br />,� .. .�.:�� C 1 li', � % i.,•/�.�t I / % ��. Y � � <br />��`�� <br />. <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _ <br />Show Number (#) of fixtures <br />A/C - air handling units <br />Forced air systems <br />I Gas pipin <br />Water heater <br />j Gas fireplace <br />; Gas range <br />Clothes dryer <br />Ran e hood <br />Exhaustfan <br />Heat um <br />Unit heater <br />� Boiler <br />KeTngerauon <br />W oodstove <br />Ductinq <br />Repair Type of Project: _New _Addn _Alteration _Repair <br />Show Number # of fixtures <br />Toilet <br />I Bathtub <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />Lavatory (wash basin <br />Shower <br />Kitchen sink & dispos <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mo{ <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 goveming this type of work will be comp <br />with whether specifed 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 auj authorized Vyy the owner o is 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 />�, �.� c� - � `' i `fi ��z <br />Owner/Authorize gent Signature Date (Revised 9/2014) <br />