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T � <br />�ERMIT APPLICATIO <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 />SITE ADDRESS: PROPERTY TAX # PER IT # <br />'� �_ � ��,�� `, ���r�_� `=_�� � �.:t. �'� :r� �',� �� �� ��`,�. M�! Jo �-I = C��C�� <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER �� `,�;, �, -�) � � � f <. �' ' . ' ' Phone/E-mail �` � a= i_ � , � <br />� <br />Address l� �� `, � City/State/Zip ��"� L�j � ��) { � �' � �,C � <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor�S Ag2fli _ T@f18f1� (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR State Lic. # �/��js/�� 7/lX ity Bus. Lic. # � 3 <br />Address Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT . <br />4'�; -�� (� �.r� E E=5-- \'l.. �-b�S._= �_� Y�a t�t:�C 1`,l�;Kx-�'- i..11��� rt_'� 1 GLYv\I�rr��;�'�e.►C'0, e 6;Y� <br />� <br />Phone/E-mail '-( �y ��� - � �� �� �� � <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK` � C.� C��:�% <br />-, ; . <br />Existing Use of Building (�i; �:,,la'�'� �- �L �/�( � ��.��]�l �_:- HEAT SOURCE: <br />Proposed Use of Building � i,��ilv � LY.I° ti r>L_-� / kt .� i�� C_- Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family �Commercial <br />Type of project: _ New _ Addition _ Remodel _ Repair �T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : I�`;�'�� (�L L_ �i�L� '��'; ('""� ��I���� �_ <br />-�=--C �- �1�� � - '����� i�'� � f�C �� ��� t ��.. � t�,��� ���+�_, ��� � �,%+=`�.�:, <br />t�;?�-l-� Y��.`.� \' -F��`_��. <br />MECHANICAL PERMITjAPPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn �Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br />Show Number #) of fixtures Show Number # of fixtures <br />- �� :i ��_ A/C - air handlin units Toilet <br />Forced air s stems Bathtub <br />Gas i in Lavato wash basin <br />Water heater Shower <br />Gas fire lace Kitchen sink & dis osal <br />Gas ran e Dishwasher <br />Clothes d er Clothes washer <br />Ran e hood Water heater <br />Z `.�:-1�.."' ' � Exhaust fan Sink service/bar/mo /etc. <br />Heat um Backflow reventer <br />Unit heater Urinal <br />Boiler Drinkin Fountain <br />Refri eration Floor drain <br />Woodstove Grease tra <br />Ductin Roof drains <br />Other ��'vl�; �'� ��_ � � 1_�` , Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM Other: <br />INumber of Heads 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 governing this type of work will be comp <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 owner of thi§ property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />� i <br />'�� � �-. . . � �-- <br />� � � �- <br />Owner/Aut rize Agent Signa4ure � „ ate �� (�sed 9/2014) <br />,, <br />