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� <br />PERMIT <br />• <br />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.c�rg <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ADDRESS: _ I PROPERTY TAX q PERMIT # <br />%,-�iI(� IALOG,�- I�AG�IM� �hf1 ,%��Li��d%�%�?i i��1j1 �ll �? Il�n — <br />LEGAL for new construction: Short PlaUsubdivision <br />LICANT: Owner <br />� <br />Owner's Agent <br />No. (attach copy of long legal description) <br />Phone/E-mail 1,�7�— 1,� (ji - <br />City/State/Zip <br />Contractor � COf1tf8ClOf�S Ag6fl1 _ T@f78fll (must provide a letter of consent from the owner to clo work in the space) <br />A✓� L& I Lic. # VD� �YEW ISq �-F COE Bus. Lic, #(�11/eGi -�i <br />TENANT BUSINESS NAME <br />� �5�� �0 2 <br />� v <br />BUI DING PERMIT APPLICATION <br />Existing Use of Building <br />�� IPhone/Email � �*�� 43G( � �5�� <br />NTACT FOR PERMIT <br />$rY�.vl (�a.lvi� � ?.��- q�1- �4,—at <br />PRICE OF WORK � I7, 1$� ,`� <br />HEAT SOURCE: <br />Proposed Use of Building �d1�AW1. fe'{'AI I IS'fGf/�DiZI�-i-t1PP, � 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) : <br />Iv�ti{�.11 (�) �ac�tl�i cc�jP uni�� <<i) �e�ckcw�� -F�, C�) �� -`���,e�,� dtic�ar��,�r���es,� �v�1�a�, ��p'� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: �New _Addn _Alteration _Repair <br />Show Number (#) of �xtures <br />(p A/C — air handling units <br />Forced air systems <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICA'�ION <br />Type of Project: _New _Addn _Alteration _Rep;�ir <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Shower <br />Kitchen sink & d <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/ba <br />Backflow orever <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />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 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 reculating construction <br />That I am authorized by the owner 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 />Z� �z � l Z <br />Owner/Authorized Agent Signature Date (Revised 6/2012) <br />