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. � <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: PROPERTY TAX # P�� IT1 � �� <br />q�� `PAc�F��- av� �Cd.�l � Z�10�3000Zoo ,00 KI�-f �2-(; <br />�AL for new construction: Short Plat/subdivision <br />NER ��ov�o�r,i�� �e...I��, + S��V;uc <br />No. (attach copy of long legal description) <br />Phone/E-mail <br />APPLICANT: _ Owner _ Owner's Agent �` COf1If2C10f _ COf1tfBCfOf S A92flt _ T2f18f11 (must provide a le[ter of consent from the owner to do work in the space) <br />CONTRACTOR PATg �p-} �; r�e._ Qro e . o,� L& I Lic. # PA-r �'Po cF COE Bus. Lic. # <br />�w '�. P.�-t r,-e �F 4': re . c.. ,.,, <br />Address 2 � 01 -t o�w � u E t. T� co ,.n� � g, 4 z Phone/Email Z s� . Z�. Zzao <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />� dt FC � � /Vbe':• `! _ � r[ • �' �•�� FGGnt I /1 <br />ro r: e(�et . r�♦ .% l.�A t/ ; / 1: <br />� Phone/E-mail Z53•377•22'7Z- Ma� .r, •it rC•GvM <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK G, 20 0 <br />Existing Use of Building <br />Proposed Use of Building Ga <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _C <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�C / Ca� � S�r','n�l��'! /`e � �iCn ..c ( //"+/f'o ✓� rc-��� <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 />Woodstove <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />2 Z, j Number of Heads <br />HEAT SOURCE: <br />Electric Other <br />lition Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatorv (wash basinl <br />Shower <br />Kitchen sink & dis <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/ <br />Backflow preventE <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 is property to perform the work for which application is made and I comply with the State Contractors Law �8.27 RCW and 296.200A WAC. <br />lZ Z�t /c{ <br />Owner/Authorized A ent Signature Date (Revised 6/2012) <br />