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� <br />� <br />� <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETf PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />ADDRESS: � � G w �V� �,{ K �✓t(, , CV �lilZi�',� PROPERTYTAX# � PERMIT � <br />�� J � r oc �3jc���vc�.� f�« ,� 9�f ��� <br />LEGAL for new construction: Short PlaVsubdivision 5 t C �1 ��'1�' 1 GGI Lot No. (attach copy of long legal description) <br />OWNER Crjrvl r1�GI SCr1 Phone/E-maii (�iZS) :3$S - G� J8� /�✓c�d� p�� l<<Fl��;:i <br />4ddress 3��" I S w m v1 I� �3 I✓�� City/State/Zip � v�/G tfi � 1'✓�} r1'� ��� <br />APPLICANT: _ Owner _ OwnePs Agent _ Contractor _ Contractor�S Ag2fit _ TBf18f1� (must provide a teuer ofconsent hom the ownar to do vrork in the space) <br />CONTRACTOR ��� ��� � � L P� U n'l.b ��1 State �ic. # I"i ri �' �1 S P 1-1 �� �� City Bus. Lic. #�ZS4I 3 <br />4ddress � 3j �[' �� l` 5 J r� Iv � �1 ✓�l �� � r�,� W� �, �` cZ 3 Phone/Email ���� )9 3 5�� 5 55 <br />TENANT BUSINESS NAME CONTACT FOR PERMIT w� h �� N�� h�J _ L� ��,��'�� P�' <br />n � ��� � <br />Phone/E-mail ��Z� � �S� ZU`}� W�hG�,y �,J ICG �"1G;;�j <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK A�l � ��, C�'�' �'�' <br />Existing Use of Building �°� `�� ~ � �- <br />Proposed Use of Buiiding t <br />Building type: _ Single Family _ Duplex _Townhouse �Multi-Family _ Commercial <br />Type of project: _ New _ Addition _ Remodel °�Btepair _ T.I. _ Sign _Sprinkler _ <br />DESCRIPTION OF WORK (additiona� space provided on the back) : <br />rC�,�l �tc,n� So,�1e vl a( (�X tlt re 5 <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Num6er # of fixtures <br />A/C — air handlin units <br />Forced air s stems <br />Gas pipinq <br />Gas fireolace <br />Clothes drye <br />Range hood <br />Exhaustfan <br />Heat aumo <br />Boiler <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />Other <br />( rlunt b�n� � <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />Bathtub <br />Lavato wash basin <br />Shower <br />I Kitchen sink & dis osal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink service/bar/mo /etc. <br />Backflow reventer inside bld <br />Urinal <br />Drinkin Fountain <br />Floor drain <br />Grease tra <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined Ihis applica6on and know the same to be true and correct. AII provisions of laws and ordinances goveming this type of work wiil be comp <br />with whether spec�ed herein or not. The granting of a pertnit does nol presume to give authority to violale or cancel the provision of any other state or local law regulating construction <br />That I am authorized by the owner of lhis property to pertorm the woAc tor which application is made and I comply wilh the State Contractors Law 1827 RCW and 296.200A WAC. <br />� �% 1 .. �' <br />� ���2..�i' G� � l (�,�:(.-�,,, <br />OwnerlAuthorized Agent S�gnature Date (Revised 4l2015) <br />