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t <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 />Z��O `1�� UiP,�. �11 <br />SITE ADDRESS: <br />�t- ,��-��f= <br />LEGAL for new construction Short Plavsubdivis <br />OWNER C.�-/-� �;� �'L,�r�7C�" <br />Address �� ���, r �`, <br />APPLICANT: _ Owner _ Owner's Agent �� Contractor <br />CONTRACTOR u,���iy-Z1 /(,I�J�y� <br />Address��� C��` �� � SE!/�„_� �,Q <br />TENANT BUSINESS NAME <br />�l��I��� �G�r- <br />PROPERTY TAX # <br />Phone/E-mail <br />City/State/Zip <br />PERMIT # <br />,,��.n � <br />(attach copy of long legal description) <br />Contractor�S Ag2flt _ TEflBflt (must provide a letter of consent from the owner to do work in the space) <br />State Lic. # �,�'�f',�J" ���. City Bus. Lic. <br />(��,3�1 Phone/Email a— 7 3 <br />CONTACT FOR PERMIT <br />������j��e,�— <br />� <br />� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /:��9 ,c <br />Existing Use of Building �� 5.�.1-�3n�•n k,�,�-� �-SSPn,� a l- <br />Proposed Use of Building /� �( <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 />. �-1�.5�L�('( O%7� � !�l i�++��i/J� Gzt����1� t1;7:-I"l <br />��Kl�-iL��,1 �� �'�,���� ��a � a�� �r iQ�i� <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteracion _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 />i Gas range <br />Clothes drver <br />A Exhaust fan <br />Heat urn <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE- <br />Gas Electric Other <br />Demolition Change of Use <br />S�k %�• L'�`� <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Bathtub <br />Lavatory (wash ba <br />Shower <br />Kitchen sink & dis� <br />Dishwasher <br />Clothes washer <br />Sink (service/bar/mop/etc.) <br />Backflew preventer (inside b <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 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 rype of work will be comp <br />w� whether specifed herein or not. The granting of a permit does not presume to give authoriry to violate or cancel the provision of any other state or local law regulating construction <br />hat I authorized by the owner of this properly to per5onn the work for which application is made and I comply with ihe State Contractors Law 1827 RCW and 296200A WAC. <br />�� - �� /� <br />OwnerlAuthorized Agent Signature D te (Revised 4/2015) <br />