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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 />ADDRESS: PROPERTY TAX q <br />; Z v 1.� S`1�=\LS �W I�l l,l � i'� �, <br />. �3� _Q <br />PERMIT # <br />LEGAL for new construction: ShoR PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER 1— Lj �j �`(� Phone/E-mail <br />Address City/State/Zip <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor'S A9eflt _ TOflafl� (must provide a letter of consenl from the owner to do work in the space) <br />CONTRACTOR � S L—. �/� L-U � State Lic. # City Bus. Lic. # <br />Address �� � 2 �� Phone/Email _ <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />� � �'��= Phone/E-mail ` 2 � � � `� � �— � �� J <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building '�=- i=-1 �-= W�i I�L-�`J ` `� � HEAT SOURCE: <br />Proposed Use of Building ���� �_- Gas Electric_ other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family �G 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 />� ( � ►�=� � � + u.,�� 2c� v �,ti���`, �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 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 / SUPPRESSI <br />Number of Heads <br />SYSTEM <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New�Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />' � � Toilet <br />Bathtub <br />C� j Lavatory (wash basin) <br />� Shower <br />'Z...._ I Kitchen sink & disposal <br />j Dishwasher <br />i Clothes washer <br />Water heater <br />; Sink (service/bar/mop/etc.) <br />; Backflow preventer <br />Urinal <br />� Drinking Fountain <br />j Floor drain <br />i Grease trap <br />Roof drains <br />� Medical Gas <br />i Other: <br />I 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 wl7ef#�er ecified 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 qm author 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 />r <br />'� ' � Z � <br />`t � <br />Owner/ uthon d Agent Signature Date (Revised 3/2013) <br />