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• <br />� <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 />ADDRESS: <br />s <br />PROPERTY TAX ti P RMIT # <br />tF �� ��fZ�� �lhf��--�02. <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER � � — C(�L.� Phone/E-mail ��S rp� ��DU <br />Address /U/() 5� �UFi2�7 /6'InC[ l�,�A% City/State/Zip �U�'�',��7' y`�2���i <br />APPLICANT: _ Owner Owner's Agent _ Contractor _ Contractor�S A98f1� _ TBflBflt (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR }�-I /2� LE Y- C���c..� State Lic. # ��� ��L/z �--��7% I�� _City Bus. Lic. #����' _� � <br />Address �� ��.,(;'�*�j� Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT ��i.l�E �v�D <br />� � �Z C Y —%OL.� Phone/E-mail �lo� �p2� �j/7 / � ' jyjQ. '`.1 <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK L� 3 S� <br />Existing Use of Building �%� L(lC/Y�I1 , l�/I USlG VFiJ� , HEAT SOURCE: <br />Proposed Use of Building C�l�!$I �2(,!C I%p�1% dVjf�%%�(;�/�{�� D��'I�C� Gas Electric <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: New Addition Remodel Repair x T.I. Si n Sprinkler Demolition <br />DESCRIPTION OF WORK (additional space provided on the back) : ��� �� S jN�C C �-5 /4' <br />t�kna� �krs��i�lC� �����1�c���c- k�f��% <br />4✓�3Z� I3���y,k��1 /�/J 5�'fit�S • f3Ui�iJ So�1� f'/z/vfi7� ����i�i` S <br />C�r►3iccr s�-rla.vs Cv rl _ l� � c- �2�� - <br />S j1G��C�6;�� <br />Other <br />:hange of Use <br />�/l/% /J/A%!yi <br />sP�rFs fi <br />� � l3iN� Sr,�.i !� �jN'E�'- > <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />A!C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler - <br />W oodstove <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer (inside bl <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 governing this type of work will be comp <br />with whether sp ein 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 arn'authorize owner o his propert to perform the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. <br />�r .. <br />C...._._ G li .� <br />Owner/ ed ure Date (Revised 4/2015) <br />/ <br />