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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 />ADDRESS: <br />PROPERTY TAX q <br />P <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER �p Ul/J (�iK<NSO Phone/E-mail <br />Address 0 ��� City/State/Zip <br />APPLICANT: _ Owner _ Owner's Agent x Contractor _ ContractoPS Ageflt _ T2fl8fll (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR IV 0�2�{{,iXi� Cl5(,o� /Li�IL�2S State Lic. #�U�%]�f��/%( D� City Bus. Lic. # � <br />Address �QUZ� �lrZN� �, Nl� �1i(,(,LQp2� , ��i'� Phone/Email ZD(� ��-� OZ /�Gt1���.oOU(//E� <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />BUILDING PERMIT APPLICATION <br />hone/E-mail i��l%�L �lc�P9 �neav r�e <br />ONTRACT PRICE OF WORK ,OOU `�`� <br />Existing Use of Building �i� 5!/,)/i/U7—/�L HEAT SOURCE: <br />Proposed Use of Building �� Gas Electric Other <br />Building type: �C 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 t�ba�: Q�� ��� yx�� D f��,�� �Q <br />1Q,GGUo UF_ ���lJ� / 8�' �a l( �j/�r7o �� � R� U- rr ' � 3%'.�lZ" fe�L�j <br />�i <br />�► %�ff�nJ R�i w�oA�L -(�S•NK f srnvF w rr( �uo 7— f3� R�"zcoc,t�-,��, <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn x Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />� Forced air systems <br />� Gas piping <br />i Water heater <br />I Gas fireplace <br />� Gas range <br />; Clothes dryer <br />� Range hood <br />f Exhaust fan <br />� Unit heater <br />� Boiler <br />j Refrigeration <br />( Woodstove <br />� Ducting <br />� Other <br />SPRINKLER / SUPPRESS <br />� Number of Heads <br />SYSTEM <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn �Alteration _Repair <br />Show Number (#) of fiztures <br />� Toilet <br />' Bathtub <br />i Lavatory (wash basin) <br />! Shower <br />f j Kitchen sink & disposal <br />� Dishwasher <br />� Clothes washer <br />j Water heater <br />I Sink (service/bar/mop/etc.) <br />i Backflow preventer <br />I Urinal <br />unnKing t-ou <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby ceRify 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 vioiate 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 perfo the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. I <br />` � <br />_Z_�s - <br />Owner/Authorized Age ' nature Date (Revised 3/2013) <br />GoµZ <br />