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C� <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 />ADDRESS: <br />PROPERTY TAX 4t <br />EGAL for new construction: Short PlaUsubdivision Lot No.� (attach copy of long legal description) <br />Address q�n0 V�4 a� 1 S�vP e-r ICitylState/Zip �h �h �rn��ti _ 1�1�Q_ �o ��► �c <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor�S AgBflt _ T0f1811t (must provide a letter of consent from ihe owne� lo do work in lhe space) <br />CONTRACTOR e�s 1r � State Lic. # �(Q].`�J City Bus. Lic. # <br />_ __ ._ __._ --_- -----_ -- -- .Itii:i�s�ic�r u_mcnl dcu��ic.t�l.iii�l <br />Address PMB 6147, 13300 Bothell Everett HWY, Suite 303, Mill Creek, WA 98012 phone/Email 360-863-2053 <br />TENANT BUSINESS NAME CONTACT FOR PERMIT �.,,� �.«{�.� �,��>�����t,i�i �� cnnuast.nrt <br />360-863-2053 <br />Phone/E-mail <br />BUILDING PERMIT APPLICA'i101d CONTRACT PRICE OF WORK <br />Existing Use of Building <br />Proposed Use of Building S�'� <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family <br />Type of project: New Addition Remodel _ Repair _ T.I. _ <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�t,�r �i�x�l Se���ct�Z�«s. <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />5how Number (#) of fxtures <br />A/C — air handling units <br />I Forced air svstems <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes drver <br />Exhaust <br />Heat our <br />r <br />Woodstove <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Commercial <br />Sprinkler <br />HEAT SOURCE: <br />Electric Other <br />Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: ___,New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />Lavatory (wash basi <br />Shower <br />Kitchen sink & dispa <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/badmc <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />i hereby certi(y that I have read and examined this application and know the same to be true and corred. All provisions of laws and ord(nances goveming this type ofwork 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 owne� oF this property to pe�form tha woric for which appl(cation Is made and I comply wiih the State Contractors Law 18.27 RCW and 296200A WAC. � <br />� � <br />