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� <br />� � <br />r Gft1Y1�T f1r r���� 1 ��IY <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 #t PERMIT # <br />� � { � /��.rr � � � � �E- I� l i-I (� �, --� �G <br />U��O O <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER � � �• � Phone/E-mail 25 -`'j�D•Zz5 C-� <br />Address 2 ,U � �~ City/State/Zip �v Z�� .- E � /� � � <br />APPLICANT: � Owner _ Owner�S A92f7t _ COnffBCfOf _ COf1tr2CfOf�S Ag2flf _ T2llafli (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR �'— '�f State Lic. # City Bus. Lic. # <br />yz-s-�s� _-».7 tP- <br />Address �,� � -�' '� Phone/Email ��;� ��`�� <br />TENAN BUSINESS NAME CONTACT FOR PERMIT <br />BUILDING PERMIT APPLICAiIOI�I <br />Phone/E-mail <br />CONTRACT PRICE OF WORK <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: _�(Single Family _ Duplex _Townhouse _ 11�lulti-Family _ Commercial <br />Type of project: New Addition Remodel � Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />� � �c�� 1- �� �� 4�� �Jr�2. ._��a��' -- <br />[ <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 systems <br />j Gas piping <br />� Water heater <br />Gas fireplace <br />j Gas range <br />i Clothes dryer <br />Range hood <br />� Exhaustfan <br />� Heat pump <br />; Unit heater <br />; Boiler <br />Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />Electric � <br />molition Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />� Bathtub <br />� Lavatory (wash basin) <br />j Shower <br />j Kitchen sink & disposal <br />j Dishwasher <br />� Clothes washer <br />� Water heater <br />i <br />� Sink (service/bar/mop/etc.) <br />I 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 lhe 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 olher state or local law regulating construction <br />That I am authorized by the owner of this property to pertorm the work fo� which application is made and I comply with the State Contractors Law 18 27 RCW and 296200A WAC. <br />Owner/Authorized Agent Signature Date (Revised 3/2013) <br />��1 <br />