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CJ <br />u <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 # PERMIT # <br />3e�o �L \,ti' cTr�� e� (� E A� E;� J E 2PT-r-, �.J w`iBLz�� I c� o�� 3 5 I�I � � i�c, z t� ( 5(7 Z-- C) i� <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description} <br />OWNER C 1 � `� � � � �i�Q�TT Phone/E-mail y 7 � , Z 5 —1 — � �� <br />Address 3 � V 1 C��F\2 S� i� U� i l.�-% � �1 �1� � City/State/Zip C�,� E lL �� T� t�% ri I� 1�� � <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor's Agent _ Tenant (m�s� provide a iener or consenc trom �ne owner to do wonc �n ine space� <br />CONTRACTOR Ti�`� �� �i� �,�iY'lG-U� L1��f State Lic. # City Bus. Lia #��� <br />Address Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />��t3:=+� Sr1N� tt'�Z- <br />f uL� C� � C' ' Phone/E-mail y 2S � 2S �- j��I (� r�c�v�c��e z�v: e��' e��•4-i,..��t `�� � <br />BUILDING PEF�MIT APPLICATION CONTRACT PRICE OF WORK cS, ��5�� ��c_:� <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Builcling Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family �( Commercial <br />Type of project: PJew Addition Remodel Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (additiona/ space provided on !he back): ►=�� ��� � L" "�'��w� �''�"''�'t �' �t�S����� c 5���2�>���«Y �io� <br />1 N� �L'liPcS` E�F T\��S 7�0.� ��7 15 To R'L�Lr\�E �"�'t �XIS'���+C EY:TrRIUR �c.�cQE��.-�-YYIEt-i�l, <br />��A�2S U'CTwE;En1 �N� W�LI.�IA✓h � . �'ho�DIZ�L.I-il�To2�� ��-�y �+w�� �- r�r �'�nu'+viLi�r1L �,jCcu�T �1tJ1DiNL` <br />�cr�zeO AT �,::pt �v EZ �"'�efd t s��� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _Ne�w _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� A/C – air handling units <br />Forced air systems <br />j Gas piping <br />� Water heater <br />Gas fireplace <br />� Gas range <br />' Clothes dryer <br />Range hood <br />j Exhaust fan <br />� Heat pump <br />i Unit heater <br />Boiler <br />Woodstove <br />�— Ducting <br />� Other <br />SPRINKLE:R / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT ,APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />j Toilet <br />� Bathtub <br />� Lavatory (wash basin) <br />� Shower <br />i Kitchen sink & disposal <br />j Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <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 re�ad 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 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 this property to periorm the work for which applicalion is made and I comply with the State Contractors Law 18 27 RCW and 296.200A WAC. •, ( <br />�}����, � <br />/ \ Ia.' `�.l t � � � � � � <br />Owner/Authorized Ageint Sigir� e Date (Revised 3/2013) <br />