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s • <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 /> SITE ADDRESS: PROPERTY TAX# R <br /> R x <br /> jl 3 �' A AGS,E I ; 2 -00 21- <br /> LEGAL <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Cote., lPhone/E-mail <br /> Address I'� ` vg– t c U P-f f l t W City/State/Zip _ z 1 <br /> APPLICANT:_Owner _Owner's Agent Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 1, ✓�t 1 I EC S State Lic.# tt3 k V5-)t 1 Z.(-1 City Bus. Lic.# <br /> Address ,J 1J�4 I �� �S�n�l` �{� 5 �/ Phone/Email Z,S 3&L-0 LL' <br /> TENANT BUSINESS NAME ( CONTACT FOR PERMIT <br /> Phone/E-mail 'Lt <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �J <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building 1` to 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(additional space provided on the back): <br /> Dry SldewAO Swr���1� Ifo ,Ve- peCK -(,P(- C �w�� <br /> 'I� - Ale- -. A4 vod Leud , <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 fixtures <br /> A/C–air handling units Toilet <br /> ! Forced air systems Bathtub <br /> j Gas piping i Lavatory(wash basin) <br /> Water heater j Shower <br /> Gas fireplace ; Kitchen sink&disposal <br /> Gas range i Dishwasher <br /> Clothes dryer ! Clothes washer <br /> Range hood i Water heater <br /> j Exhaust fan ! Sink(service/bar/mop/etc.) <br /> Heat pump j Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration j Floor drain <br /> Woodstove j Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <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 permi�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 authorized by the owner of,Jftis pro erty3o pe56rm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner/Authorized Age. Signatur ((( Date (Revised 3/2013) <br />