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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.evereitwa.org <br />SITE ADDRESS: <br />�l� �"Ac1�iG <br />LEGAL for new construction: Short PlaUsubdivision <br />OWNER Y�O�CI� ���s(� <br />PROPERTY TAX k PERMIT # <br />2�o53aa�2A�ta� �; j?,��� - C� <br />Lot No. (attach copy of long legal description) <br />hone/E-mail <br />;ss (�2 ( �`�� AV� . ICity/State/Zip �.YE�T`I� � �d��`c • ��2..0 �o <br />LICANT: _ Owner � Owner's Agent _ Contractor _ Contractor'S A9211t _ TBI1811t (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR <br />� �zc c�-r� g��. <br />�i _- ._,_ - 'Si .r!c�'r.-_`_ , _�. <br />TENANT BUSINESS NAME <br />�ES�ltc�-E � (Gt-(�4t� F1t�rt� w•�.r-r�� <br />�."�'Qc(ef�I4G�-iFC2�{Z1f�iC�e �- L>L��'� <br />BUILDING PERMIT APPLICATION <br />BUS. LIC. # <br />IPhone/Emai� <br />CONTACT FOR PERMIT <br />�vc�-�t �aYc�Gt� l� +_,_, (__�� <br />Phone/E-mail � 1,5 • 2�.� • b�nB�aGYI�'F� `T �G� <br />CONTRACT PRICE OF WORK � (�L.��GY'd, !3d <br />Existing Use of Building t-i�t-t"'iYL,- HEAT SOURCE: <br />Proposed Use of Building�-C�Ci� Gas_ Electric Other_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family X Commercial <br />Type of project: New Addition x Remodel Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : µ���-t'js,cC.� 1S �I.CX's�.T�FICa f�'h dIJ��T'lG—�-1� <br />�-C?�,c. +yta�-cr�aSzt � 8 uL�t�'�)�-c.� �E�.�1 �c�s -rra #-_c u���t� �.a�cc-�z. <br />��`iC �7E.-�T', �t-lc,-�l3GTI �11� (1 i t-1E�e�! �t-(��to�Z ��-C-t�GF-1 r ^�'-"=—��- �� t-1 t� <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 />I Gas piping <br />I Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryei <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />rtetngeration <br />Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Bathtub <br />Lavatory (wash basin <br />Shower <br />Kitchen sink & dispo� <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/moF <br />Backflow preventer <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 goveming 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 perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br />/ <br />g' �+' �'f? <br />Owner/Authorized Agent ' e Date <br />L � <br />(Revised 3/2013) / <br />