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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: PROPERTY TAX # P�RMIT # <br />�aa ��r��- ��� - . _ <br />LEGAL for new construction: Short PlaUsubdivision FrIC�Q}{' <br />'NER �'fC.�i��l �1� <br />ress a � U �2..1� <br />LICANT: _ Owner _ Owner's Agent <br />No.� (attach copy of long Iegal description) <br />Phone/E-mail �ZS 3 <br />P � <br />� <br />Contractor �[ Contractor'S Ag01lt _ T61l8t1t (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR ���(� ��Z,VI <br />Address ��p `$ m � �v� ��(1/ � <br />TENANT BUSINESS NAME <br />BUILDING PERMIT APPLICATION <br />� L& I Lic. # �'�IDKU�SI1 COE Bus. Lic. # <br />��q,���� Phone/Email p�(p �c����7� <br />CONTACT FOR PERMIT <br />L..bui� lJ2¢�1�e�+�.`.�2— 2D� S7/ � fc� <br />Phone/E-mail i <br />CONTRACT PRICE OF WORK ���, � • <br />Existing Use of Building S�� HEAT SOURCE: <br />Proposed Use of Building �� �10cM.��i Gas ✓ Electric Other <br />Building type: V 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) : F �(Z� pq yv�/q C;E �cU�r' <br />'�oV�� ��la,Ge_ ih�'e✓�iof �rhishe� �v� � $W►oK, F'ir'� �W�t.f�'" <br />d�o.x�..�¢.. . �-1-r� �-ur�1 ra.�ir5 �'c�raw j n� , <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteretion V Repair <br />Show Number (#) of fixtures <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 />Z. Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration <br />Show Number (#) of fixfures <br />2 I Toilet <br />/ <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/e <br />Backflow preventer <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 orized 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. <br />. ;. ��� <br />`� 8 ! 3 <br />Owner/Authorized Agent Signature Date (Revised 6/2012) <br />