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� � <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: PROPERTY TAX q PE MIT # <br />/'L i 2uc izc /1vL. "v� rt� �� A. `!�: Z� i Cc' S 5 34r " z. � ic' j�'v �(�jC � �'� �`� <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER'%/}cd��-� 7�p:.r..w �' ,�c�t�k �if��li�t�. Phone/E-mail ��=j - Z7 ( - ZdY-� <br />Address �`Z! ,2uc�.t /2 /�►'�- t-1�L= �e: 7 L�. i+ �`Gc'( City/State/Zip L-1�[./ZE l%� GC' �'±: lc i <br />��. , <br />APPLICANT: � Owner _ Owner�5 Ag01lY _ CO�lf8CI0f _ COf1tf2CtOf�S A9Bf1� _ T0118f1t (must provide a letter of consentirom the owner to do work in the space) <br />CONTRACTOR �`��'�'i.i2- �-f i�rix•i��� State Lic. # City Bus. Lic. # <br />Address �:y ..,� Phone/Email �Lj -Z�'��14�'�' <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />�r�br�, M• Ti�-Gz�'.'`1 <br />Phone/E-mail �T�,- 2��/ - 1%�.r-sf <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORF(%1�Cx.t��:c�c <br />Existing Use of Building �%�r�`-Zc�s/S�c;� HEAT SOURCE: <br />Proposed Use of Building w�'�aF-i.'ak'f'�:..►'s.�v /[-�tl�s�=��=i Gas Electric_ Other <br />Building type: i� 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 (additional space provided on the back) : <br />�tl�`1.�:.7�L La� I S"7</� c, '''" DlLic-��s�-cj� �'S "!c'%LXCi; /.[t"a`�: u L'itfc-�jt"r6iZ'- �°`�.�)G�[c:� f`-��tGL-l'Z�� � <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fiztures Show Number (#) of fixtures <br />� A/C - air handling units � j Toilet <br />� � Forced air systems � Bathtub <br />� i Gas piping y. Lavatory (wash basin) <br />i Water heater j`. Shower <br />Gas fireplace ; Kitchen sink & disposal <br />j Gas range j `,Dishwasher <br />i Clothes dryer i Clothes washer <br />; Range hood Water heater <br />E Exhaust fan � Sink �service/bar/mop/etc.) <br />j Heat pump Backfl6� preventer <br />I Unit heater Urinal <br />i Boiler ' Drinking Fa ntain <br />Refrigeration'�.. Floor drain <br />i Woodstove j Grease trap <br />Ducting ; Roof drains <br />� Other � Medical Gas <br />SPRINKLER / SUPPRESSIOM SYSTEM I other: <br />Number of Heads �\ 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 authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. 1� <br />6 7 <br />C/ <br />�2� � l � �� � �-�-�� � f z/ ��.�'3 <br />Owner/Authorized Agent Signature �ate (Revised 3/2013) <br />