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• <br />s <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ADDRESS: E� PROPERTY TAX # PERMIT # � <br />� 3�a ��C�-S ���- u1P�- �i 8 ao � o o�{ 3�' r� 9�� 7 od Z �� l< <br />for new construction: Short PlaVsubdi <br />JNER .� B rr� y� jri <br />Iress � � o�`�- � <br />PLICANT: XOwner <br />J <br />�Nt� S� . <br />_ Owner's Agent _ Contractor <br />CONTRACTOR Q W�,(�((,- .Je (tir. 1[.uJ �e � <br />Address q$ oZ,'j -,2� (t � rf! 5, l�•� �� <br />TENANT BUSINESS NAME <br />BUILDING PERMIT APPLICATION <br />�dLLot No.�_ (attach copy of long legal description) <br />Phone/E-mail ��o " �j � p — f n ( � 7 <br />ICity/State/Zip ���� � w�,- q g o a o <br />CO�f�actof�5 Ag0f11 _ T0�2111 (musl provide a letter of consenl from the owner lo do work in lhe space) <br />_ , . fA <br />L&ILic.# <br />aQ IPhone/Email <br />ITACT FOR PERMIT <br />Phone/E-mail <br />CONTRACT PRICE OF WORK <br />Existing Use of Building'S1 �_ q�} n �� � <br />c � <br />Proposed Use of Building S� ha I -�Qn,.�a � VI <br />Building type: � Single Family _ Duplex _To nhouse _ Multi-Family _ Commercial <br />Type of project: New _ Addition Remodel _ Repair _ T.I. _ Sign Sprinkler <br />COE Bus. Lic. # <br />-�i8• I�fS� <br />HEAT SOURCE: <br />Electric � Other <br />olition Chanqe of Use <br />DESCRIPTION OF WORK (additional space provrded on the back) . I� <br />�2 �� a� e a- � a,(� s s w��ke d�e��r' s i[3'� � l; b vl ��Z �Z-h ✓� t� V po w'�� ��� �,� ��� �; �, <br />1►, s�. h ard, w i►� � -� �r= �� C u(� ��� V � 0`�I a� , <br />1 h s�-�U.d� C'� 1� a-►. 1�1. a-�a X=� �,e �� ��fi"5 <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />S ow 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 />� lothes dryer <br />R ge hood <br />Exli�ust fan <br />Unit h <br />Boiler <br />� Other <br />SPRINKLER / SUPPRESS <br />� Number of Heads <br />EM <br />of Project: _New _Addn _Alteretion _Repair <br />Show Number (#) of fixtures <br />Toilet <br />I. Bathtub <br />; Lavatory (wash basin) <br />' Shower <br />i <br />� �Kitchen sink & disposal <br />� ishwasher <br />j othes washer <br />I W er heater <br />Sink service/bar/mo <br />Backfl w preventer <br />Urinal <br />Drinking untain <br />Floor drain <br />Grease trap � <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify thal 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 granling 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 propeRy to perform the work for which application is made and I comply wilh the State Contractors Law 18.27 RCW and 296.200A WAC. � <br />/ �.,, �t.� �' � � t; "� ,� .! �,, �iC <br />': � '' � { � ' ' ��, , � , L. <br />(.. � ��v � � , <br />_ ._ .' ' . _ . _. . r._._ /o...,i�..rJR/7n�71 <br />