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� <br />• • <br />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 />ITE ADDRESS: <br />�i o S c�.`%.�s ��'e _— u ri, <br />. <br />EGAL for new construction: Short PlaVsubdivision <br />OWNER� , ,�-{��.,bh, � <br />Address ��CS� ���,5 � h�-�- '�j <br />APPLICANT:� Owner _ Owner's Agent _ Contractor _ <br />CONTRACTOR � VS �� <br />Address� v � �J �Q�� ��,�_ �/1��'� <br />PROPERTY TAX # <br />0 3 a <br />'�GS.��tot No3 <br />G�(� D� � r.}�' ����� ���� <br />(attach copy of long legal description) <br />Phone/E-mail `F,J� -.l�{ /- <br />ICity/State/Zip <br />Contractor's Agent _ <br />TENANT BUSINESS NAME <br />� �� �-�� ���� � �:.1y �t��� <br />BUILDING PERMIT APPLICATION <br />State Lic. # <br />�� e.r •l`C�SPIo�� �' � <br />-. _ � . �^ �ti'''�q J 1• C� fti, <br />T8fl811f (must provide a letter of consenl from the owner to do work in the space) <br />Citv Bus. Lic. # <br />Phone/Email � �� ��v�— <br />�a�-3�����> <br />CONTRACT PRICE OF WORK <br />Existing Use of Building `- ' - ,.1, HEAT SOURCE: <br />Proposed Use of Building �� u / Gas Electric Other_ <br />Building type: _ Single Family _ Duplex _Tow house _ Multi-Family _ Commerciai <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) : r � � G <br />1`��� T 4� ti C7� aC � � J ��i'0 0 11r� �,1f�(� li% OV �.e� �� Gi . Q. 1 Q C� `'�'� C.1 ql U� l <br />�ns�o,\ ��.o.� d-� coe,Q c s.� 1'� o.�� �, n�,.b.�ls �►, 1az.ar�p6v�r��' <br />c c�nve F� try� I�" rcx� i�n i rtt� b� cs� 1 <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair Type oi�Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures � Show Number (#) of fixtures <br />I A/C - air handling units Toilet <br />`�, � Forced air systems \ Bathtub <br />Gas piping `� I Lavatory (wash basin) <br />Water heater `'�j Shower <br />, Gas fireplace !� Kitchen sink & disposal <br />-� �'Gas range Dishwasher <br />; Clothes dryer ; ' Clothes washer <br />j Range hood i 1Nater heater <br />j Exhaus �fan Sink ��ervice/bar/mop/etc.) <br />Heat pum�S. ' Backflow.preventer • <br />Unit heater <br />Boiler <br />i Refrigeration <br />j Woodstove <br />I. Ducting <br />� Other <br />SPRINKLER / SUPPRESSION S TEM <br />� Number of Heads <br />Urinal \ <br />Drinking Founi in <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby ceRify 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 qj 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�,� <br />e �� � <br />Owner/Authorized Agent Signature Date (Revised 3/2013) <br />