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• • <br />PERMIT APPLICATION <br />BUILDING/M�CHANICAL/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: <br />� <br />LEGAL for new construction: Short PlaUsubd <br />OWNER <br />�� �LL�. <br />RTY TAX q <br />���il`r <br />P�RMIT, # <br />No. (attach copy of long legal description) <br />Phone/E-mail <br />0 <br />ress (�j JI`.:) �_'oj�,'_'f C����'C,,1 �A�(.�•�,j ICity/State/Zip �:.�.f l:''� t':}(:� (��)�; � d�� L_L�y <br />'LICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor's Agent X TBflBflt (must provide a lette� of consent from the owner to do work in the space) <br />CONTRACTOR �,�,%(P�%L1(;;�y' C'(1,��/�j(„J�('�",t_�,IC.'c i `..i <br />Address f i �.' ✓ ,-}: �`� 1 1'rtYe �j � '� �:U I I (�� �'' � _1_� <br />TENANT BUSINESS NAME <br />I�et�.! C� n�t��c�r ls �� r�1.esS P C6 : LL.�. <br />( � i �-T� <br />BUILDING PEI2MIT APPLICATION <br />State Lic. #�}�,���JT�i�:,1�� i�at1 �3 City Bus. Lic. #� ��}. <br />��:� ���'Y� Phone/Email <br />CONTACT FOR PERMIT <br />�e,�nc���er�-%�ylc� a0�-2Z�s-2�2-7 <br />Phone/E-mail �tay\o� �� s'ykc �cnS�lt�nc� .c_c� <br />CONTRACT PRICE OF WORK l�"> C�Z� <br />Existing Use of Building �� Dc HEAT SOURCE: <br />Proposed Use of Building TC�e Cb(`��llil L�Ii 1CC���Ibl1S 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) : r L.... <br />�lU�l�� ► 1 v<. l r`1�.V-S �v' �����iJ6'1����`-='�L �4;e-k'�1.. �%� �if.;�C` �'��i�iUli 1C'�t.;� . CL���►�-;f`(�9; 1-1 <br />�.�'�y.;ilt����C� TC �'.� �\C�.Ct�C� �C�C- ��\`� �1� (�C``�C' - <br />MECI�ANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: �`� New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� � A/C — air handling units <br />Forced air systems <br />i Gas piping <br />; Water heater <br />Gas fireplace <br />i Gas range <br />Clothes dryer <br />Range hood <br />; Exhaust fan <br />i Heat pump <br />Unit heater <br />Boiler <br />; Refrigeration <br />Woodstove <br />Ducting <br />l ( Other ��c��r�'; 't�-.' <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />� Bathtub <br />j Lavatory (wash basin) <br />j Shower <br />I Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />I Water heater <br />! Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />i Medical Gas <br />Other: <br />i 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 complied <br />with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel ihe provision oi any other state or local law regulating construction <br />That I a authorized by the owner of this property to periorm the work for which application is made and I comply with the Slate Contractors Law 18.27 RCW and 296.200A WAC. �� <br />� /G�- � �� i l <br />iy <br />Ow er/Authorize�d gent Signatyr Date (Revised 3/2093) <br />