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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ITE ADDRESS: PROPERTY TAX q P MIT # <br />ud z s. ,�n,, k,` 1�„ ,� I,,.Q . 2 9� s� iiu� �ao o� r� `:% i z�(�� - C� �-�1 <br />LEGAL for new construction: Short PlaUsubdivision Lot No <br />OWNER <br />Phone/E-mail <br />(attach copy of long legal description) <br />0 <br />Address g0 Z £ .� �� �L i .t�,�[� %3 � U �. I City/State/Zip � (�,�C`.e.fii-!/ � (� � _ � �' ZO 3 <br />APPLICANT: _ Owner �, Owner's Agent _ Contractor _ Contractor�S Ag6111 _ T@f10f1t (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR /3 ,,e_ ` � L L' L& I Lic. # COE Bus. Lic. # <br />Address ��� � y� � g L � Phone/Email Z S�. - y 7 3- O 6'� s <br />TENANT BUSINESS NAME CONTACT FOR PERMIT ��sSe�� �^�'= <br />' ° �''� 1 ;; �. � �� °-� t l Phone/E-mail �/l � Z f 7 � 3 � f (��4nc�� Eu�.i`e't� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK .J� %�, S�UC� � L� O_ _ <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building 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 (additiona/ �s'ace provided on the back) : <br />j�e_,�.c� v � 4 hUC %5 �p ).A- C.-�. � k �'S '� i'►� � /Zo o � <br />MECHANICAL 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 />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Ketrigeration <br />Woodstove <br />( Other <br />PRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatory (wash <br />Shower <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/b� <br />Backflow prevei <br />Urinal <br />Drinking Founta <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />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 lo 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 />� . �,�1 �-- � z 6�� � <br />wner/Authorized Ag Signature Date <br />`" � <br />(Revised 6/2012) <br />