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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 />� --C� Z' <br />SITE ADDRESS: ,, PROPERTY TAX # P RMIT # <br />�1C� � L ��4 '� <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER �� J'�}-t � j(� '� �� �j �—�.� Phone/E-mail ��c} C� � `� `��✓� <br />Address �j CitylState/Zip L(,( �(J l�C� e'"r �/�� �l <br />APPLICANT: _ Owner _ Owner's Agent Contractor _ Contractor�S A9e(lY _ T@f1811t (must provide a letter of consent from lhe owner lo do work in the space) <br />CONTRACTOR ,��l' l�. LL State Lic. #��C,` �� V'6�City Bus. Lic. #�5�� <br />Address 3C� 0�j ��� I L"Gi �.� �(� Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />Phone/E-mail � ' � < < ��7, J � � J � � <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �� K-- <br />Existing Use of Building S i __ HEAT SOURCE: <br />Proposed Use of Building 1�5 l Gas_ Electric_ Other_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />T e of ro'ect: New Addition Remodel Re air T.I. Si n S rinkler Demolition Chan e of Use <br />DESCRIPTION OF WORK (additional space provded o�the back): �-�� �, � �,� S l � /� � '� � � <br />������J �j �ti1��� � C- �c�� P v � �kOl�l �1.� <br />� � �Uv�e���� d V'c��v� <br />� <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />, <br />Type of Project: _New_Addn _Alterati� epair '� � Type of Project: _New_Addn _Alteration Repair <br />Show Number (#) of fixtures Show Number (#) of Fxtures <br />A/C — air handlin u its 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 />;�xhaust 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 Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM ( Other: <br />Number of Heads Other: <br />I hereby certify that I have readand�gxamined this application and know the same to be true and correcL All provisions of laws and ordinances goveming lhis type of work will be compl <br />with whether specifi,gd herem or nof 7fie g�a"ntRignf,a permit does not presume to give authonty to violate or cancel the provision of any other state or local taw regulating construction <br />That I am cyth"bnied by the, oWnelniihis propertq�toi`52�the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. <br />�—�--- <br />-- _---- a � i � � <br />Owne� r¢ed Agent S' ature ate (Revised 9/2014) <br />i� �_---' ' <br />✓� <br />