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� <br />• <br />PERMIT APPLICAT90N <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 />SITE ADDRESS: � PROPERTY TAX t# P MIT # <br />�'7 3v ��E�iL"-� JS.�.,�F�, �1i.��"tT� V'� Ui''`-�"3�1 I (�� �I ?��:� �l! [�', <br />e <br />LEGAL for new construction: Short PlaUsubdivision ��� 1� ���. [�����ot No. (attach copy of long legal description) <br />r <br />OWNER �ip,�'' . . � � � �..1�� �'�� Phone/E-mail � �� �r — 3�SU �� �•�� <br />Address � � ���� j�}� s^ City/State/Zip ���- � �`' <br />-0� <br />� <br />APPLICANT: ' Owner _ Owner�5 A9BIlt _ COf1ff0Ct0� _ COfllfeClOf�S AgBflt _ T8f12f1i (must provide a letter o( consent from the owner to do wo�k in the space) <br />� /� � <br />CONTRACTOR j ' V �- [,,,�,l�,' State Lic. # �� R� '� p� s. Lic. # <br />Address � � _j �j ���-Sf '�l��� C i Phone/Email �� � � ,���t� <br />TENANT BUSINESS NAME CONTACT FOR PERMIT � � <br />r � ���-��i i�Sbi,W�� <br />� �'l. f/:� 4—l� l � � ��. r/` � � I � Phone/E-mail � v �J�L`� � t � ,'G��' L 1 `b� � `a. � ����ry OV Cil�' � <br />� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ' <br />Existing Use of Building �� L ZL- %,� � HEAT SOURCE: <br />Proposed Use of Building�%�'� � G.r�r�li��r�i-� Gas r/ Electi <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � mmercial <br />Type of project: New Addition �model Repair _ T.I. _ Sign _Sprinkler _Demolition_ <br />DESCRIPTION OF W_ORK (additio�l space provided on the back) : <br />��(�;��-����n ��� ��etJ��'�v�'Is .:.G���;l/�� �-c����� a�l�-,,��,�c>��r�s 1/��_ <br />� ,�! , <br />���v <br />� �-��'��,� � t c� <br />J� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />f Forced air systems <br />i Gas piping <br />� Water heater <br />Gas fireplace <br />j Gas range <br />Clothes dryer <br />` Range hood <br />� Exhaust fan <br />j Heat pump <br />; Unit heater <br />! Boiler <br />; Refrigeration <br />� Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Other <br />Change of Use <br />>>�r,-, �1 <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />j Toilet <br />� Bathtub <br />Lavatory (wash b� <br />Shower <br />Kitchen sink & di� <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/ <br />Backflow preventE <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby ceRify that I have read and examined this application and know the same to be true and correct- All provisions of laws and ordinances governing this type of work will be complied <br />with whether specified herein or not. The gr of a per i es not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I am a o�zed by th�ner of this prop y to perfor he - k for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />/� ` 17 <br />/ j � ,� _ G� <br />/��/� < � �r��� �� <br />O er/Authorized Agent Signature Date (Revised 3/2013) <br />