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� <br />� <br />PERMIT APPLICATION <br />BUIL�ING/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 # PERMIT # � <br />�� � I tti �c� ,�, ��Y�. ,��=-�v�:; _ ���� �. � ��� li� z� � �- l ��o � ��,v � �o � - t,� <br />LEGAL for new construction: Sho�t Plat/subd <br />OWNER fV,.5��1 �"� i <br />Lot No. (attach copy of long legal description) <br />� �-C _-i;j �� 2�'�'3 , <br />� Phone/E-mail /;..,,1,,.,.•.,�,��a ��1r1/Gi,% <br />City/State/Zip <br />PPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor'S A92fli _ T0(18f1� (must provide a letter of consent from the owner to do work in the space) <br />ONTRACTOR '���►�C/7 State Lic. # City Bus. Lic. # <br />TENANT BUSINESS NAME <br />�� C-��� � Cl.`�i�`i�'�� �-����.� <br />BUILDING PERMIT APPLICATION <br />�Phone/Email <br />CONTACT FOR PERMIT <br />Phone/E-mail <br />CONTRACT PRICE OF WORK <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas Electric Other <br />Building type: _ 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 provide�i on the back) : � �' �..r. <br />�z��r � r�5�1 �l�lL- �'�'�'c}c,� S-t�,,� c tC�.3'�; �/H �'c.�i � 5 ��� 1��� �� �� <br />�Z�T �%<"3 /� f� ��1/I lt rLlr,ial � G��l'V% G'i��l� �� � Wt;j�%G� . ( � r I�E' f��C� r / <br />l / <br />MECHANICAL PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C - air handling units <br />I Forced air systems <br />i Gas piping <br />i Water heater <br />Gas fireplace <br />I Gas range <br />; Clothes dryer <br />Range hood <br />� Exhaust fan <br />i Heat pump <br />; Unit heater <br />� Boiler <br />; Refrigeration <br />Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <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 />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 />r <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 conslruction <br />That I am authorized by the owner of this propeRy to peAorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />�.��� � � I�h � �� � � <br />Owner/Authorized Ager�Signature Date (Revised 3/2013) <br />