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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBIN G/SIGNISPRINKLER/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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE A ESS' . PROPERTY TAX# PERMIT#,",ft,Wft,,,,',1Jf� <br /> 00 00 4t) <br /> LEGAL for new construction: Short PlaVsubdivision ____ Lot No.__..._,.,.._ (attach copy of long legal description) <br /> OWNER ,1 �a�rl �,." PhoneiE-rnail <br /> Address 6 �- I t�r' City/State2ip el 102-15 <br /> APPLICANT:_Oamer Owner's Agent _Contractor Contractor's Agent Tenant Onost provide a leUei of consent iroro the owner w do%vori,In the space) <br /> CONTRACTOR <br /> (r+ L&I Lic.# COE Bus.Lic.# <br /> Address PhoneEmail ill <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> 45�✓y }1LIAV4isl,c 5i ta��an€� t'¢t�ctirriL <br /> Phone)E-mai Cj <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building_..LV4 (/� -'-. - HEAT SOURCE: <br /> Proposed Use of Building W _..... Gas_. Electric_ Other__ <br /> Building type: -Single Farnily Duplex_Townhouse Multi-Family _X Cornmercial <br /> Type of project: _New _Addition _Remodel _Repair T.I. Sin _Sprinkler Demolition Chane of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): ►C.V)A r1l•"r Jy M1�f i�^��1 - ��,Jliii <br /> ►'V�t Dl i oEf e P�1 �Y` OA 1)V4C ` ^-itil) <br /> �Y iVV� Y i�AAi ►'fi 'QQ1q <br /> W 11`t �l' 5 rev hoc i1�r'C '10 its —N -0�4 ► ice- , A Mezt l . � <br /> txo <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project _New_Adds Alteration_Repair Type of Project: Now Addn _Alteration_Repair <br /> Show Number(#)of fixturos Show Number(#)of fixtures <br /> A/C-air handling units Toilet <br /> Forced airs stems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> ! Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer I Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> DuctingRoof drains <br /> Other_ Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM other: <br /> Number 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 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 law regulating construction <br /> That <br /> I am autho/jri/z}d by t k wrier of this pr perty to perform the work for which application is made and I comply with the State Contractors Law 18 27 RCW and 296200.A WAC. <br /> OwnerlAuthorized Agent..S' nature Date (Revised 612012) <br /> ��Z <br />