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� � <br />PERMIT APPLICATIt�N <br />BUILDING/M�CHANICAL/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 />ADDRESS: <br />L for new construction: Short PlaUsubdivisio <br />ER <br />PROPERTYTAXit <br />No. (attach copy of long legal description) <br />Phone/E-mail �175 -" `1L 'S � <br />P <br />PPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor's Agent _ <br />CONTRACTOR �+� /� G NIO� �.�a►..•1 <br />4ddress ��-3� (�j w���C(� �q� <br />TENANT BUSINESS AME <br />BUILDING PERMIT APPLICATION <br />State Lic. # <br />. �'�Z % : <br />CONTACT <br />(must provide a letter of consent from �he owner to do work in the space) <br />ov z �3 i yo 2 ��ty Bus. ���. # <br />Phone/Email '3Gv yZ2 ��O/b <br />R PERMIT ��M T�ItI3dr'J <br />ione/E-mail �-j� � -f-�uy <br />ONTRACT PRICE OF WORK <br />Existing Use of Building <br />Proposed Use of Building Gas. <br />Building type: �Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler _De <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />S � 1��. E/� +�; �� f�-� T�6 <br />MECHANICAL PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />j A/C - air handling units <br />� Forced air systems <br />Gas piping <br />' Water heater <br />! Gas fireplace <br />I Gas range <br />! Clothes dryer <br />� Range hood <br />� Exhaust fan <br />Heat pump <br />; Unit heater <br />--� Boiler <br />I Refrigeration <br />� Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />.i. �s-o� <br />HEAT SOURCE: <br />Electric Other <br />olition Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />i Bathtub <br />� Lavatory (wash basin) <br />� Shower <br />j Kitchen sink & disposal <br />I Dishwasher <br />j Clothes washer <br />i Water heater <br />� Sink (service/bar/mop/etc.) <br />� Backflow preventer <br />I Urinal <br />i Drinking Fountain <br />( Floor drain <br />I Grease trap <br />j Roof drains <br />� Medical Gas <br />j Other: <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be irue and correct. All provisions of laws and ordinances governing this type of work will be complied <br />with whether specified 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 am authorized by the owner of this property to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />���--- 3/�/ 'lz <br />wner/Authorized Agent Signature Date (Revised 3/2013) <br />