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• <br />• <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: � � f� �.CJ l '1 PROPERTY TAX # PERMIT # <br />c�`>��7 ��.� Ct'�S� v�� l�di, h L��,V'Lii i,)_�lC�T ���J�l-i`�vo:�CL/.:1C%E= -'� ) —O <br />v�, LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER �� 11 u o � 1� LLa. �n, � ct e-V' <br />Address �S j � , I, L ';,.�� �� <br />� i� � APPLICANT: _ Owner _ Owner's Agent _ Contractor <br />G CONTRACTOR L�G.L' . t��'� �� �`' �T �LZ,V� <br />Address � � � ��,} � S�' �'f' - <br />TENANT B�ISINESS NAME I <br />�„". [�i � CG'- � h<� � 1� P r i� I 1�� r YLi� <br />� <br />BUILDING PERMIT APPLICATION <br />1 <br />Phone/E-mail �,�,�"�C�- �,�nl� ���G{'��i�i:-�L��'t� <br />� <br />City/State/ZiP �" �jt �N.� ��C..'� � �� ,�; Q `� <br />Contractor�S A9Bflt _ T0�8flt (musl provide a letler of consent from the owner to do work in lhe space) <br />r��v' L&ILic.#FI�T`NGS�5�j3�i�- COEBus.Lic.# <br />Phone/Email�(�(, '�l�(< � y(�S y C�,�:Yi' �"o:: (i !� i� <br />CONTACT FOR PERMIT � �y� ;], �L <br />�i: �- U ..� � � (3 YY! 1 - <br />Phone/E-mail �} � � - � 7 5�- �i' �7C' £J f�:v kc , n�� �'�e ��1 �_;`t4: � • s �vr, <br />CONTRACT PRICE OF WORK •� 1 �(,' CJ . C t' <br />Existing Use of Building � <br />Proposed Use of Building �+�- � � vlP..�V � �'�a •�" �t� �,` � cr;�-���'�- <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />HEAT SOURCE: <br />Other <br />Type of project: New _ Addition Remodel Repair _ T.I. � Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additiona/ space provided on the back) : <br />/�1 s�w1 l �� ✓N ,✓'+� 3` x�` a1 l,�-wl,t. v� �,�,,,� L_ C� 1 N� D s: F f J i`,hh �v i�� <br />'�' ��� ����`'� i�- ;� Yl D V�.— �� e�t�' � c, o� l 9 0 l,i � V �O u S� v�� S S � C, p v�r� v� 1"rGc <br />r <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I A/C — air handlina units <br />Gas piping <br />Water heater <br />Gas ran <br />rtange nooa <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Ductinq <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />of Project: V New _Addn _Alteration _Repair <br />Show Number (#) of fi�rtures <br />Bathtub <br />h <br />Kitchen sink & dis <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/i <br />Backflow preventE <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certrfy 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 authoriry to violate or cancel the provision of any other state or local 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 comply aiith the State Contractors Law 18.27 RCW and 296.200A WAC. <br />I � <br />i v / /1 <br />� lJ L (9 / 'lL '1' �-- (1J � /� � I , �5 <br />Owner/Authorized Agen ignature '� Date (Revised 6/2012) <br />��� <br />� <br />