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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 www.everettwa.org <br /> SITE ADDRESS: -;� _ PROPERTY TAX# P MIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER J�CIJA)E)J L, Phone/E-mail IFZS Z(rS—JZ/ <br /> Address -2 r'C) t� f 7/f�(� f'L City/State/Zip 1fC "L'. 1 T <br /> APPLICANT:X Owner OOwner's Agent _Contractor —Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR U'✓vN State Lic.# City Bus. Lic.# <br /> Address SA N(E Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail (�t,f2 S) -24s,— /Z 94 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building (\t::� 1 J)ESV( 14 L S HEAT SOURCE: <br /> Proposed Use of Building ,5��/ ]E .S¢2 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 /> c r7•% �=:\I S j t N C�- �E c �' . R�r3t..f !t: � , ,q►�� (�'X�� L<t N l�t 1�% G �"/✓� s��'�,eS <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 /> I Forced air systems Bathtub <br /> j Gas piping Lavatory(wash basin) <br /> Water heater j Shower <br /> Gas fireplace j Kitchen sink&disposal <br /> j Gas range I Dishwasher <br /> Clothes dryer Clothes washer <br /> i Range hood Water heater <br /> j Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump I Backflow preventer <br /> Unit heater j Urinal <br /> j Boiler Drinking Fountain <br /> Refrigeration j Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other ! Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: <br /> Number of Heads I 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 authorized by the own e•of this property to perform the work for which application Is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> Owner thorized Agent Signature Date (Revised 3/2013) <br />