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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 />ITE ADDRESS: PROPERTY TAX # NtKmi i� <br />i i��� C�'h�s��n�cf �� c.r�4.�s���a:���c;���1 �i�U� <br />EGAL for new construction: Short PlaUsubdivision Lot No.� (attach copy of long legal description) <br />����r���� <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractors Agent _ Tenant �m�5� Prov�de a ienerotconsernrrom me owner to do Work �n ina SPa�e� <br />CONTRACTOR e�s Y y State Lic. # ��Q1�3 City Bus. Lic. # <br />---- --- Jaki•s�Ic��cl�J;i>>cnLu:cui�i��a�t.ttct <br />Address PMB 6147, 13300 Bothell Everett HWY, Suite 303, Mill Creek, WA 98�12 phone/Email 360-863-2053 <br />TENANT BUSINESS NAME CONTACT FOR PERMIT I;,I,rs<Ic�rloi>incn� ri.c�mu�:st.nrt <br />360-863-2053 � <br />Phone/E-mail <br />BUILDING PERMIT APPLICAiION CONTRACT PRICE OF WORK <br />Existing Use of Building <br />Proposed Use of Building S�2 <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 />�G� � T' r� �.�1�5��'�tl c r�5 . <br />MECHANICAL PERMIT APPLICATION <br />pe of Project: _New_Addn _Alteration_Repair <br />Show Number (#) of fixtures <br />A/C — air handiing units <br />I Forced air svstems <br />Gas fireplac <br />Gas range <br />Clothes drye <br />RanAe hood <br />Heat pump <br />Unit heater <br />n <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />_ Commercial <br />n Sprinkler Demolition_Change of Use <br />PLlJMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of Fxfures <br />� Toilet <br />I Bathtub <br />Shower <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/b2 <br />Backflow prever <br />Urinal <br />Drinking Founta <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 compiied <br />with whether spec�ed 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 regulatfng construction <br />That I am authorized by the owner of this property to periorm the work for which application Is made and I comply with the Staie Contractors Law 18.27 RCW and 296200A WAC <br />� � <br />