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L� <br />• <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUIVIBING/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: � �O � ���5 ['�-"��� <br />LEGAL for new construction: Short PlaUsubdivision <br />OWNER �C.C)�/S <br />Address ��� � <br />APPLICANT: �Owner _ <br />CONTRACTOR j'�/� <br />Address Z� 0 Z <br />TENANT BUSINESS NE <br />5,�, � v`��-S <br />S S t�t/ � /l)1.�� <br />PROPERTY TAX # I PE�,2M�T� � � / � <br />� <br />Lot No. (attach copy of long legal description) <br />Phone(E-mail 25 � � S� z 5 '� ( S <br />City/State/Zip � �/-Q. � �►4 � $ � ' <br />Owner's Agent _ Contractor _ Contractor'S A9Bflt _ TEIl8ft1 (must provide a letter of consent from the owner to do work in the space) <br />L.�,A^1 2f/`r-,nl I/Ilo�S State Lic. # II/l�� l,`(.�Q �—City Bus. Lic. # <br />I� <br />iail <br />NTACT FOR PERMIT <br />"/ � Phone/E-mail �� �C-�•l'�V <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building sIPJ2.4- �TrY'1�'� <br />Proposed Use of Building S�� G� <br />Building type: _ Single Family _ Duplex _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 />�� ��,,..� ��- <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 svstems <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 />Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />'ys �f�3 -55z5 <br />HEAT SOURCE: <br />� Electric Other_ <br />olition Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Num6er (#) of fixtures <br />� Toilet <br />I Bathtub <br />Shower <br />Kitchen sink & dis <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 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 state or local law regulating construction <br />That I am a orized by the owner of this property lo perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />�it� ��.�,'%�i3 ' �. <br />��, r <br />Owner/Authorized ent Signature Date (Revised 3/2013) <br />