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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 J# PE IT <br />;� ; rv � ;� �-�- S�,/ �,�-� i,Ji� �zc�� � I �� - C l �- <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER �. �r�,-�" I�, „� �� Phone/E-mail ���j - c��'�� C� :3� /ic� 0 ecs�,>yCcy� .,..c <br />ress I'�/C.� �"r1 ` 5�.� i�-��� � <br />'LICANT: _ Owner _ Owner's Agent _ Contractor <br />CONTRACTOR <br />P <br />Contractor�S AgBIIY _ T2f18f11 (must provide a letler of consent from the owner to do work in the space) <br />State Lic. # <br />Bus. Lic. # <br />Address Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT �^ <br />—�� ��"�fi n� L.. <br />�,1�/} � <br />��"�� '.� : Y �(Ul�✓��'�''Y--- Phone/E-mail `%� "� -' -� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK O�" .�C,� <br />Existing Use of Building �,��a.Jr:��c.rS�C% HEAT SOURCE: <br />Proposed Use of Building ��/c���!-•t�.�S C.� Gas_ Electric_ Other_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (additiona/ space provided on the back) : <br />J �� �1 �--fJ �� =J � �'1 ��CJd�'G�1 <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� A/C - air handling units <br />i Forced air systems <br />; Gas piping <br />i Water heater <br />Gas fireplace <br />j Gas range <br />Clothes dryer <br />Range hood <br />1 Exhaust fan <br />j Heat pump <br />; Unit heater <br />� Boiler <br />Refriaeration <br />� Ducting <br />j Other <br />INKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />+.,-��:n � I <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fixtures <br />j Toilet <br />� Bathtub <br />I Lavatorv (wash basin) <br />5nower <br />Kitchen sink & disposa <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/� <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 thal 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 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 6v the owner of this �rooertv to �erform the work for which application is made and I comply with the State Contractors Law 16.27 RCW and 296.200A WAC. <br />I�� <br />(Revised 3/2013) <br />