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� <br />� �PERMIT APPLICATI�I <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />TE ADDRESS: PROPERTY TAX # RMIT # <br />1�5 Is M,��a�.� �� . �D 3�i3y d0000 Z�laa �3�; ��Z� <br />uAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />/NER -� bu,�� � L��ov.g Phone/E-mail 2.C�(i 52. �' ZL Z`S <br />Iress �,� ,�j � p City/State/Zip ,r � Q �l 8 2'� Q <br />PLICANT: _ Owner _ Owner�S A9ei1i _ COIltf2CtOf _ COf1Yf8ClOr5 A9@flt _ T0f12f1t (must provide a letter of consent from the owner to do work in the space) <br />�NTRACTOR �� �? I`� l,� t\ L'� C,l ' C�Li�,��� & I Lic. # COE Bus. Lic. # <br />Phone/Email <br />TENANT BUSINESS NAME ` CONTACT FOR PERMIT S� ;�� <br />,S� �� �A �' � � e CX r �w .�/l �J�/1 Lt �-L_ <br />Phone/E-mail 'L,pfi �2Z.i - ?jp'Z <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK -!�iC%L' <br />Existing Use of Building �I✓c� \� �� C'.�� HEAT SOURCE: <br />Proposed Use of Building N/� 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) : <br />�\\\1 1 I � � 1 �n �e. 5 <br />P i �. t� � av� � e r r� ac 'h o G� U O � r t�n• o i e rG. �� � V� EG(�s , <br />C�� ��.b l�e a�..� 1 e..� �, P�e�a L�e'� r�� <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />A/C — air handling units <br />Forced air svstems <br />Water heater <br />Gas range <br />Clothes dryE <br />Range hooc <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Aiteration _Repair <br />Show Number (#J of fixfures <br />Toilet <br />Bathtub <br />Lavatorv fwash basinl <br />5nower <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/b� <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certrfy 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 I am authorized by the owner of this property to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />e� �— 2�—iz <br />Owner/Authorized Agent Signature Date (Revised 6/2012)� <br />/T <br />