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� • <br />PERIVIIT 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 vwvw.everettwa.org <br />SITE ADDRESS: PROPERTY TAX �i PER IT # <br />(,�� oc� ��r_2��LL ����� I� P�cw-� 2�?e�4 Dz.c%o 3z�z��� �� Q�� Q� <br />LEGAL for new construction Short Plat/subdivision Lot No. (attacn copy of long legal description) <br />OWNER Gi <br />f U <br />L �Phone/E-mail <br />�p SY-F V �L.�L. �.v �� 1ni fl `�l �((� <br />T: _ Owner _ Owner's Agent � Contrector _ Contractor's Agent _ Tenant �m�sc Pro��de a �ene� or �or,5e�c r�om me owr,er to ao work m ine sPa�e� <br />CONTRACTOR /-f /'� (�-1 � �L C.(� !� 5 i /l (,"� <br />Address � � � � �� 'ZV �'� >'�' <br />TENANT BUSINESS NAME <br />T�QC�� <br />BUILDING PERMIT APPLICATION <br />�:.� State Lic. # f� �- LE-E � � z t"( ��ify Bus. Lic. # <br />%e�T ��� yv� ., Z��� - zt <br />�i z �. Phone/Email �. � �� �� - <br />CONTACT FOR PERMIT � <br />T�- �� c���'�� <br />Phone/E-mail <br />CONTRACT PRICE OF WORK <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair T.I. 3iqn Sprinkler <br />DESCRIPTION OF WORK (additiona/ space provided on the back) : <br />HEAT SOURCE: <br />Demolition <br />Other <br />/��,c+� l Z CQ 2 li� $ �,J '�c2 �c/F��a 13 fp A-c c..r,�,�,r+1yc ,�a-�-z fon.. N€��cJ ��-�G -uj� <br />A„�, t�r Dz+k I�p'�+�^ �" S�'MGe . <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />' A/C — air handling units <br />Forced air systems <br />Gas piping <br />i Water heater <br />j Gas fireplace <br />� Gas range <br />Clothes d er <br />� Range hood <br />� Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />� Ducting <br />[ Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Z-- Number of Heads <br />PLUMBING PERMIT APPLICATION <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 & 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 />L � .h lY-iL]� ✓;- <br />,. C�.�J <br />I hereby certify Ihat I have read and examined this application and know the same ro 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 authonty to violate or cancel the provision of any other state or local law regulating r.,onstruction <br />That I am authorized by the owner of this property to perform the work forwhich application is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. <br />�'�% ��� �-z� - � 5 <br />Owner/Authorized Agent Signature Date (Revised 9/2014) <br />