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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 vwvw.everetiwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS,{: �- ✓� ���r� ts�j4 PROPERTY TAX # �P��2,� MIT # <br />�� � i: % �;/ � �� � f1 V��-. S L-. c� �5�� �'� ✓ �I � ���" � � ��- <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of Iong legal description) <br />OWNER E ��,t. �, i 1 � p 5� "� Phone/E-mail ' � -- // �t S <br />Address � E-j 2 � � Lj . v �� �,;� � City/State2ip L �, � � �;,, � � . , i•4 � "� �: ( <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor�S A9ef1Y _ T2f12f1Y (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR /I.IC l3�(I ��t„S i�:�Z�c L& I Lic. #�lt; o�J,Si� �-� ��' COE Bus. Lic. # <br />Address �GC� � J S' ;�` �(., S �, � ( � �/�'t� /� ��,t Phone/Email /�,� � � � 5��� �f� / %� <br />TENANT BUSINESS NAME CO TACT FOR PERMIT <br />��i L� ii <br />G ;l c�'c ,f1 i ,c. -"'/p� E K• — Phone/E-mail � S � .� 53 '�// � � <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �S(�C7 • G�' <br />Existing Use of Buiiding <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-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 />S r� �t �` �r � E-� � � �!/�,0 dl �LM.P��� <br />� �,n� a �- <br />HEAT SOURCE: <br />Electric Other <br />of Use <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures Show Number (#) of fixfures <br />A/C - air handling units Toilet <br />Forced air systems Bathtub <br />Gas piping Lavatory (wash basin) <br />Water heater Shower <br />Gas fireplace Kitchen sink & disposal <br />Gas range Dishwasher <br />Clothes dryer Clothes washer <br />Range hood Water heater <br />Exhaust fan Sink (service/bar/mop/etc.) <br />Heat pump Backflow preventer <br />Unit heater Urinal <br />Boiler Drinking Fountain <br />Refri eration Floor drain <br />Woodstove Grease trap <br />Ducting Roof drains <br />Other Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM 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 goveming this type of work will be complied <br />with whether spec�ed herein or not. The granting of a permit does not presume to give aulhority to violate or cancel the provision of any other state or Iocai law regulating construction <br />That I am authorized by the owner of this property to perForm the work for which application is made and I compty with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />' `/� <br />Ow uthorized Age ignature Date (Revised 6/2012) <br />