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� • <br />�ERIYII� /`1�r�I�����1V <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 />�ISITE ADDRESS: PROPERTY TAX q P RMIT_#%'� �. <br />� �-S %J, '''�f-�:�vL'-Y �% /� _-�I �1;� ��1�.�✓ <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER � ` ,= , � 7—.� , � L L Phone/E-mail z ,� � -- � / � -- : --�, � / <br />Address , j �i � /J?Jy. �, � � S � / r ��/ City/State/Zip L� (� c'; • r' %�' ;,� r � ;� C' / <br />APPLICANT: _ Owner _ Owner's Agent � Contractor _ Contractor�5 A92fif _ T0118f1t (musl provide a letler of consenl from lhe owne� to do work in �he space) <br />CONTRACTOR `��, , /- -�, ; _>'; r �� �, �- t�� .-[ � State Lic. # �C�.,� ��� �� L �� �5�/� G City Bus. Lic. # <br />A�.� S �) �S -� � 4� f � <br />Address �_i0s '^�l`>�� ,�-. - i G`� s�/3 �1t�Ss' • i %J '��" Phone/Email '�•,,`r-i".: ) ': '..t✓, c .-�"7 <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />' �� . t/' �r � <br />° �Z _ S �. �r <br />_.� �e' �� ./_.) G -C. � ii-i r' - <br />Phone/E-mail � �1�. � �t . � ti � �a� ,�s-�! �,_�y'<, <br />BUILDING PERMIT APPLICATIOfd CONTRACT PRICE OF WORK ���t �% <br />Existing Use of Building S fi" ���' ���-S HEAT SOURCE: <br />Proposed Use of Building S�N ��a �'� �, Gas_ Eiectric 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): �� S�;,; <br />�� � �'�� � Y �-> x.S T� ��-� s ,s�� �. �'> /, � -��L L � 1 <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 />� Gas piping � Lavatory (wash basin) <br />Water heater j Shower <br />Gas fireplace j Kitchen sink & disposal <br />( Gas range j Dishwasher <br />Clothes dryer � Clothes washer <br />; Range hood ; Water heater <br />� Exhaust fan � Sink (service/bar/mop/etc.) <br />� Heat pump I Backflow preventer <br />� Unit heater j Urinal <br />; Boiler Drinking Fountain <br />i Refrigeration j Floor drain <br />Woodstove i Grease trap <br />Ducting I Roof drains <br />� Other j Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM i Other: <br />Number of Heads ; Other: <br />I hereby ceRify 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 />wilh whether specified herein or not. The granting of a permit does nol presume to give authority to violate or cancel the provision of any other state or Iocal law regulating construction <br />That I am authorized by the owner oi this property to peRorm the work for which application is made and I comply with the State Contractors Law 16 27 RCW and 296.200A WAC. / <br />� �� Z <br />-� � __s �;� - � `� <br />Owne /Authorize Agent Signature Date (Revised 3/2013) <br />