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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 />/ r< / � /��: vl ¢ _� <br />LEGAL for new construction: Short PlaVsubdivision <br />OWNER �� � � ,/� � Q 7C <br />Address � �'r 1 ��G� e j � <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor _ <br />CONTRACTOR ��� � /G��i S CO✓J��tY" • <br />Address �%� � i �l0 `''"r.j ���u� S��G9 <br />TENANT BUSINESS NAME <br />BUILDING PERMIT APPLICATION <br />PROPERTY TAX # <br />Lot No._ <br />Phone/E-mail <br /># <br />(attach copy of long legal description) <br />� L; <br />ICity/State/Zip <br />Contractor�S A98ftt _ T811211f (must provide a letter of consent from the owner to do work ln the space) <br />State Lic. # <br />��-� �Phone/Email <br />'ACT FOR PERMIT <br />I SC'�cv aUs. ���. # <br />Phone/E-maii ��y///f �f j � �'s ��_S`Z�� -- rj`l <br />��� <br />CONTRACT PRICE OF WORK ��� �%) f� � L�' <br />Existing Use of Building �'� S� �i f/tc( l� �t'C+�'�/vrt�C'� HEAT SOURCE: <br />Proposed Use of Building � JC. � 7 i Vla1 � 6 �Cc j/y►�1 �1 �}� Gas_ Electric Other_ <br />Building type: _ Single Family � Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel � Repair _ T.I. _ Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additiona/ space provided on the back) : <br />� a._rc�c� -� _ Y� �. 5 t� e— i v� s u( Q� j' e, <br />f�c; � vi t <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />i Forced air systems <br />j Gas piping <br />I Water heater <br />Gas range <br />Clothes dryer <br />Rangehood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />Ducting <br />( Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Numbei (#) of fixtures <br />� Toilet <br />Bathtub <br />Lavatory (wash basin) <br />i Shower <br />i Kitchen sink & disposal <br />! Dishwasher <br />; Clothes washer <br />' Water heater <br />Sink (service/bar/mop/etc.) <br />I Backflow oreventer <br />� <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: �—{�l, � <br />Other: <br />I hereby certify lhat 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 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 Confractors Law 18.27 RCW and 296.200A WAC. <br />A <br />��' ;���: � - � Q l 3 <br />Owner/Authorized gent Signature Date (Revised 3/2013) <br />