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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 />ADDRESS: <br />PROPERTY TAX # <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER �q���sc.-. �7r'�! ' %7C i 1°L �`<''S/� Phone/E-mail <br />Address � ,� � � �^� •' j�y� �Ue �l.E'rL_ City/State/Zip <br />APPLICANT: _ Owner _ Owner's Agent Contractor _ Contractor�S A92llt _ TBIl2llt (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR :Jc, ;'�•» , _S C •� J' � � ate Lic. # ?�� � 5'%%�;,� City Bus. Lic. # <br />/ �Gc GG/ 7��y <br />Address �� y S f['w.f,F'� • d ��, i:-�s�����+L Phone/Emaii t�c e' •7'' " f• _ <br />7ENANT BUSINESS NAME CONTACT FOR PERMIT <br />...��r � �SU/( I�t+/5 r <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ����^✓�� <br />Existing Use of Building /nu/fi �q�n� j�l ����unz�-.z� HEAT SOURCE: <br />Proposed Use of Building Gas Electric Other_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family �ommercial <br />Type of project: New Addition Remodel Repair _ T.I. Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION/ OF WOR/K (additional space provid/�ed on the6 back) : /� <br />��' lC'. c"c' l'C' �. i� b[�'� � .� `4�/ `y' /�CILGr'f'C �'�-� rc( /� S <br />F.'c i�.�� t- S�!� � <br />,�o���� i�� r� / S,.1Y5 <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures Show Number (#) of fixtures <br />A/C — air handling units <br />I Forced air systems <br />j Gas piping <br />; Water heater <br />Gas fireplace <br />j Gas range <br />Clothes dryer <br />Range hood <br />� Exhaust fan <br />i Heat pump <br />; Unit heater <br />Boiler <br />; Refrigeration <br />i Woodstove <br />Ducting <br />; Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Bathtub <br />wash basin <br />Shower <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <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 governing this type of work will be complied <br />with whether specified herein or not. The granting of a permit does nol 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 pertorm the work for which applicalion is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />/".> .�� - ._ i 7% <br />Owner/Auth, Agent Signature Date <br />(Revised 3/2013) <br />