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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.ev��rettw�!org <br />' <br />SITE ADDRESS: PROPERTY TAX 4k P RMIT # <br />� �„�r c,��v�. tvvRETi ,�A �Q�lL7�'� <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER T21S�'1/� <-f�Cf'��C�-�S Phone/E-mail -�"L•> ��� \=� 10\ <br />Address City/State/Zip 13El-l-l'.V �-%E�`+v''`� <br />APPLICANT: _ Owner _ Owner's Agent � COf1lf8C10f _ COf1tf8CtOf�S A90f1Y _ TBI1811t (must provide a letler of consent from the owner lo do work in the space:) <br />CONTRACTOR ��_ L, � State Lic. # City ESus. Lic. # <br />Address lF.'?�l�'( �� ZU��� �� Phone/Email 1��"� �i� � <br />TENANT BUSINESS NAME CONTA6��FOR- MIT <br />,�'�J i��V� ��C CGi�! �l�' IK,T�lC1�1' � �C�1 ��,�� ��"3�> v`-�� -��� � <br />Phone/ -mail mk� Vk'1�1 "' «t'111�� Y�ti' `(Y'(_d � 1 E�-%Y� <br />BUILDING PERMIT APPLICATION C TRA PRI E OF W RK <br />Existing Use of Building � � HEAT SOUF;CE: <br />Proposed Use of Building �` `� Gas Electric �1� Other <br />Building type: ;� Single Family _ Duplex _Townhouse Multi-Fam� Commercial <br />Type of project: New Addition � Remodel Re � T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (additional space provided o e ack�;, <br />� vJ�l C� G�1 �i l t�� �O �_, l, `�`� �4� t " � �C�' S . ��1� i.��-C, S �D 1 Nc:� , '�t (�1 � <br />F�riC � � , ��CT�U� C �� � t—t NS� 1.;� �= 1l� �-� <br />MECHANICAL PERMIT AP CAT10 PLUMBING PERMIT APP'LICATION <br />Type of Project: _New _Addn _ lteration� Repair� Type of Project: _New _Addn _Alteration _Repair <br />Show Numder (#) of fi tures Show Number (#) of fixtures <br />A/C — air h ndling units � Toilet <br />! Forced air s stems j Bathtub <br />j Gas piping � j Lavatory (wash basin) <br />; Water heater ; Shower <br />Gas fireplace I Kitchen sink & disposal <br />j Gas range i Dishwasher <br />Clothes dry Clothes washer <br />Range ho cJ ; Water heater <br />i Exhaust an ; Sink (service/bar/mop/etc.) <br />j Heat ump � Backflow preventer <br />; Unit.heater Urinal <br />Boiler Drinking Fountain <br />i Refrigeration Floor drain <br />Woodstove Grease trap <br />Ducting Roof drains <br />� Other i Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM Other: <br />Number of Heads i Other: <br />I hereby certify that I have read and examined this application and know the same to be true and correcL 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 iaw regulating construction <br />That I am aujhorized by the owner of this property to perform lhe work for which application is made and I comply with the State Contractors Law 18.27 RCVV and 296.200A WAC. <br />^�_ _ .... <br />r......-A�:....-.�:_=� �� /��L <br />__'i— �"°,- / � l <br />Owner/Authorized Agent Signature at <br />(Revised 3/2013) <br />