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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 />SITE ADDRESS: <br />2(t� �r�._i�' iC <br />LEGAL for new construction: Short PlaUsubdivisio <br />PROPERTY TAX # <br />Lot No. <br />PERM17 # <br />(attach copy of long legal description) <br />OWNER � Y� Phone/E-mail <br />Address City/State/Zip <br />APPUCANT: _ Owner _ Owner's Agent � Contractor _ Contractor�5 AgOflt _ TBI18111 (must provide a letter of consenl from the owner to do work in the space) <br />CONTRACTOR ��1R[�l\t�L ��I�i '—C; State Lic. # ��j � C( � p City Bus. Lic. # <br />Address Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />� '(� lc� - `�k�.- �-1G��1 L? <br />�=y' .. tiJ�t�c��-S _�J�ir��t)/l <br />t,• Phone/E-mail '��,� ;. � �ir� r i i✓� �_ •-� a%i E r. CLXr � <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: _ Single Family _ Duple Townhouse _ Multi-Family �Commercial <br />Type of project: New Addition �Remodel Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />� �.rL��N �� t r�� �( �� vi ��.�` v�`� <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 />� Forced air systems <br />i Gas piping <br />I Water heater <br />Gas range <br />Clothes dryE <br />Range hood <br />Exhaust fan <br />Heat pumo <br />' Boiler <br />i Refrigeration <br />j Woodstove <br />i Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />Electric Other <br />on Chanqe of Use <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 & disposal <br />Dishwasher <br />i i Clothes washer <br />; Water heater <br />i Sink (service/bar/mop/etc.) <br />� Backflow preventer <br />I Urinal <br />i Drinking Fountain <br />! Floor drain <br />I Grease trap <br />,I Roof drains <br />� Medical Gas <br />( j Other: S'A11. ��az:�D nrc vu�r <br />, � � <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 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 slate 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 296200A WAC. <br />nature / / Date � (Revised 3/2013) <br />