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u <br />PERMIT' APPLICAiION <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: „ PROPERTY TAX q PERMIT # <br />�-� � L� 1 �r,�.7.c ���-h-- �;, �.��t� 3 y-� �� � � �-� � �y � � y� �.� <br />�_.n_,,� ,�„ , ��w �, �� <br />EGAL for new construction: Short PlaUsubdivision �� 1`Tl r�'"� �— �+� `•� - Lot No. +� � (attach copy of long legal description) ��N <br />WNER fl�i'`�'1�►�j^� � LE'�L�� �t-�r�' • Phone/E-mail 't7� ��y� �� � <br />�dress Z( ( �� � J'y� (j�a�'" � CitylState/Zip �' "vl`'-t�`� �''`� � � �C' <br />PPLICANT: � Owner _ Owner's Agent _ Contractor _ Contractor�5 Ag@f1t _ TB�BfIf (musl provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR G'v�NZ—{L State Lic. # <br />Address � Phone/Email -- <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />�,'-�y� r� �-x <br />� ~ �' PhonelE-mail 'L � 1 `7 � �� � <br />BUILDING PERMIT APPLICAiIOIV CONTRACT PRICE OF WORK �' <br />Existing Use of Building n'�1�� iC� <br />Proposed Use of Building � `f <br />Gas <br />:ity Bus. Lic. # " <br />. r� _ i ��. <br />� � �'ii� 1� <br />� <br />o� <br />HEAT SOURCE: <br />l3uilding type _ Single Fami � Duplex �To�vnhouse _ Il4ulti-Family _ Commercial <br />Type of project: New A Remodel Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (additional space provided on �he back): <br />� �-�-v �j �� �'-�` I S'j ) � C�j L �1yz� a � � _ <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 />I Clothes drye <br />; Range ho <br />I Exhau fan <br />� He pump <br />� nit heater <br />� Boiler <br />Refrigeration <br />; Woodstove <br />Ducting <br />� Other <br />PRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />� Toilet <br />� Bathtub <br />I Lavatorv (wash basi <br />Shower <br />Kitchen sink 8 isposal <br />Dishwash <br />Clothes asher <br />Wat eater <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 ceRify lhat 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 oiwork will be complied <br />wilh whether specified herein or not. The granting of a permit does not presume to give authority to violale or cancel the provision of any other stale or local law regulating construction `� <br />That I am authorizyd by the owner of this property to perform the work (or which application Is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. "� <br />:, �"I� -j y <br />