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� <br />• <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 />SITE ADDRESS: PROPERTY TAX it PERMIT # J <br />Z� l % l _� �. r v�. � .' �_ 'i-v � � I � � Z C�C� ? <br />LEGAL for new construction: Short PlaUsu <br />Lot No. (attach copy of long legal description) <br />/NER ���,*-� _�� ��(' - �w�� �- Phone/E-mail �-t 2�— � - � ,3 � <br />ire5s I YZ°� �-�.•.c.�c;� �� �, City/State/Zip L dr �-J-p`� l.�� Z� Z�� 1 <br />PLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor's Agent _ Tenant �must P�ovide a ienerorconsen� rrom cne owner �o do wor� in cne space� <br />CONTRACTOR �.1 I ,F�-�-(, S� rJ �� v S��'L-'�nC1 � U,ti State Lic. # � A-�C S ��'1 K y City Bus. Lic. # <br />Address ��v j� x � Zl� L� (i �c.,:�iri'' �.i�f- �t(( �;•� L.3 2. � Phone/Email L• � <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />���..;t �r.e�t� L � •'�•'h. c�.'l �� f- �c '_" `�� � S Phone/E-mail V '� '� �1 !i /iLL1S��+ � <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK '� 5'GC' - L'U <br />Existing Use of Building 6ci �=�=I C_ r- ' � <br />Proposed Use of Building S i3�-L�`� <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: New _ Addition Remodel _ Repair � T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />HEAT SOURCE: <br />Electric� Other_ <br />— �— <br />olition Change of Use <br />Cti / �,+ � ` 7 t� . �:. �._ l,L' �. <br />G- !t� � 'r/—�f�r � - hc<<.�' r��` � . ."`�Gr�/ t.. L�,('. <br />J <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fixtures <br />A/C - air handling units <br />1 Forced air systems <br />j Gas piping <br />i Water heater <br />Gas fireplace <br />Gas range <br />; Clothes dryer <br />Range hood <br />� Exhaust fan <br />i Heat pump <br />i Unit heater <br />I Boiler <br />Woodstove <br />i Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />, : �� ,." Number of Heads <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />I Bathtub <br />Lavatory (wash basin <br />Shower <br />Kitchen sink & dispos <br />Dishwasher <br />Clothes washer <br />Sink (service/bar/m <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 />41,C <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 olher state or local law regulating construction <br />That I am authorized by the owner of this property to pertorm the work for which application is made and I comply with lhe State Contractors Law 18.27 RCW and 296.200A WAC. <br />�Z— � �� <br />Ow r/Aut o z d en Signature Date <br />(Revised 3/2013) <br />