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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 vwvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />E ADDRESS: , . � �j � J` PROPERTY TAX # P� "RMIT # _, � <br />�� �3� 5t: �7�� 4� �� 15 7 x�� ��'� I�'llyl�� `��� <br />LEGAL for new construction: Short PlaUsubdivision <br />� ��! � ��u� <br />�n `fiv N�-(� <br />�ve,-z; � I�l� , <br />, S��i k l?�b <br />Lot No. <br />Phone/E-mail <br />City/State/Zip <br />(attach copy of long legal description) <br />���i'v"� ��/l� -l.'��� <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor '�ContfBCtor'S Ag2f1Y _ T@f18f1L (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR ��f '�� I�%�'-�`�`���"i L& I Lic. #.���`��`�'��5y f�2 COE Bus. Lic. # i��� :�SC <br />Address 7�"y �i,'`yl"h �CY"`Gc`� j�t" • `�Z�.�( ��"/j� �� j ��� Phone/Email v+)�: "'�%F, .� "" � ^I `I i <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />1 �� (;,,r�� <br />����'. il�.,�Jjv�1 (.2n'TY �"or r6���'' ML:uLs�t�nw,ir Phone/E-mail ^rtiC� -i6 �- IZ`1 4 p„„k� :X ', r,�t.b�e�rv+�'u,nhw�. k'•+ <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK _�S ,�l �3- �v <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas E <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition ✓ Remodel Repair `� T.I. _ Sign _Sprinkler _Demolitioi <br />DESCRIPTION OF WORIK (additional space provided on the back) : I� <br />yY�t'v�/1.[J'\ 1`�V1 :-� TV�''� C�� G�.^iJ✓�.-� ' 1i^tA/,l {F3�.� �:tG�'L'wC� ./;L�l✓� �.i(�1� �%��� �S � �"� <br />�,�`, �ynr � SL�n ��) ;�ri,�iP.^�S-� TM'�S �/!il"'tticn�! � G»ti�± �'�; ��� / c��r'1-vSr�S <br />I � <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 ranoe <br />Clothes drye <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeratior <br />W oodstove <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />of Use <br />C l � .� ���� j`LJdGv1 <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Water heater <br />Sink (service/bar/ <br />Backflow preventi <br />Urinal <br />Drinking Fountain <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 specifed 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 perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />���'i--- � � �� l ( � �� � <br />Owner/Authorized Agent Signature Date (Revised 6/2012) <br />