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� i <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 # PE MIT # <br />�'2c,•�''Z-� I-�l.P�,�y�„/�j: l�/�� '`y�-' �Il'_ 1 ' �,•�'-1 _ � � o� <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER (�'�1 .{�.� '�j,� l, � , hone/E-mail ��,/�i ��> � - (G��JI <br />Address City/State/Zip <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor's Agent � T8f18f1t (must provide a letter of consent from the owner to do work in the space) <br />;, . G <br />CONTRACTOR L& I Lic. # COE Bus. I�� .# <br />Address �p"`►'�/�� �+�-��I��CTIG�.� � �r✓ Phone/Email(�Z 74'�' �i�,jj <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />(� �' f�l �.fj j.�. ii_. TA`(�.��� r� �� �') ''l �' Z- 7 7 i�: <br />Phone/E-mail -}�c� ��,�- �{P�� � i �i.✓C1�I � U nG��•C. •��� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �i a��� cFr=� <br />Existing Use of Building Ct�j=rC�% dA.'��,��;;,� HEAT SOURCE: <br />Proposed Use of Building �-'����G�� (�,/►r<,�i-i��`cic=. Gas Eiectric Other <br />,� — <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: _ New _ Addition _ Remodel Repair I. Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />��'��.:;��` �%��� r,�Fl�� lf'/�� R� f'�,�?C� Cr'ri�.�� f� �'/�.�z7�T�ty r <br />, ..�'' 4� '�'if�r't-l���r�✓t j <br />MECHANICAL PERMIT APPLICATION PLUMB G PERMIT APPLICATION <br />Type of Project: _New _Addn �Alteration _Repair pe of Project: ew �C Addn �Alteration _Repair <br />Show Number (#) of fixtures Sh Number (#) of fixtures <br />� A/C - air handling units 2, Toilet <br />i Forced air systems i Bathtub <br />Gas piping " � Lavatory (wash basin) <br />Water heater ; Shower <br />Gas fireplace I Kitchen sink & disposal <br />Gas range Dishwasher <br />Clothes dryer Clothes washer <br />Range hood Water heater <br />Exhaust fan ! Sink (service/bar/mop .) <br />f Heat pump � Backflow preventer <br />Unit heater � , rinal <br />i Boiler � D king Fountain <br />Refrigeration I Floo rain <br />Woodstove Grease rap <br />Ducting Roof drai <br />� Other Medical Ga <br />SPRINKLER / SUPPRESSION SYSTEM j 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 auth ' y e o�yrtej of this property to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />Owner/Autho�fized lCgen�ignature Date (Revised 6/2012) <br />