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� • <br />PERMIT APPLICATI�N <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITI�N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 42�257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ApD�S : ��� / PROPERTY T X ii �, PERMIT # <br />��J �� �:3 ��5c�.� �l �-�` c r 3 t 0- 0 <br />LEGAL for new construdion: Short PlaVsubdivision Lot No. (attach copy of long legal description) <br />OWNER LJ-��(,� / Z.- �,� ��/%%�/�.�� L_� PhonelE-mail �J '��Q � 7ab <br />Address ,�C' ,t�' !�j:�j CityJState/Zip ��,l� L(,���C9� LV � Dl.� � K� <br />APPLICANT: __ Owner _ Dwner's Agerrt � Cor�tractor __ Contractor'S Ager�t _ Tenant (mustprrnidea letterofconsentfromtheownertodownrkinthe space) <br />CONTRACTOR '�IL� r�0 (.��/i��J�CLL(' (�0�(..� L& I Lic.# ���,�>..}-L~.-�G�%�f I COE Bus. Lic.# <br />r r <br />Address �� � C I-1�� j�' . f� /iIt- I�P�'c�.a ��/}- �j��73 Phone/Email �(c�' 3'�'3,�� p�(,e9%.(.a� �� Q <br />TENANT BUSINESS NAME CONTACT FOR PERMIT G'f Qf��,� CG-,L� .�yF-•Cp/1 <br />L-CI- <br />OU�''``✓ ����e� C0• n� L•Ci��' Phone/E-mail 3/�!i-3�-3�3q �vi�c,� � P�'Sr"dr'o� cca� <br />BUILDING PER MIT APPLICATION CONTRACT PRICE OF WORK __�CG�C� ______ <br />Existing Use ofBuilding _���iY�-1����C <. Ly' ��-l�� HEATSOURCE: <br />Proposed Use ofBuilding� �a��-�i�>'Z���`'�1,'`'�S �' � L _ ���� Gas Electric Other <br />Building type: _ Single Family __ Duplex__Townhouse __ Multi-Family � Commercial <br />Type ofproject: New Addition Remodel Repair__T.I. Sign__Sprinkler__Demolition_Change ofUse <br />DESCRIP110N OF WORK (addi5onal space p ovided on the back) : • <br />.O�m �� ��'�� � � �� , �e� --��oo e,���, ��-;��v tj .c��� d oo �.g — Te �r � �� <br />I�J �Zr�-{��� I �.-�-- -�ly� S ��� �-f-iL�� . �( �u✓1G� � Pv�GL 1��Lk��l.e� <br />_ , <br />MECHANICAL PERMIT APPLICATI�N PLUMBING PERMIT APPLICATION <br />Type of Project: __New __Addn __Alteration _ Repair Type of Project: __New _Addn _Alteration __Repair <br />Show Number (#j of fixLures Show Number (#) of fixrures <br />A/C - air handling units Toilet <br />Forced air systems Bathtub <br />Gas piping Lavatory {wash basin} <br />Water heater Shower <br />Gas fireplace Kitchen sink & disposal <br />Gas range DisYrwasher <br />Clothes dryer Clothes washer <br />Range hood Water heater <br />E�aust fan Sink (servicePoar/mop/etc.} <br />Heat pump 6ackflow preventer <br />Unit heater U�inal <br />Boiler Drinking Fountain <br />Refrigeration Floor drain <br />Woodstove Grease trap <br />' Ducting R oof drains <br />Other Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM other: <br />Number of Heads Other: <br />Ih ebycertifythat Ihave read and examined this application and knowine same to betrue and correct.Nl provisions of laws and ordinances goveming this lype ofwork will be complied <br />with ied herein or not. The granting of a permit does not presUme to give authorityto �iolate or cancel the provision of any other state or local law regulating construction <br />That a authoriZed bythe owner ofthis propertyto perform the workforwhich application is matle and Icomplywiththe State Contractors Law 1827 RCW and 296200A WAC. <br />� �� ���� <br />Owner/Authorized Agent Signature Date (Revised 62012) <br />�l� <br />