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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 />ITEADDRESS: � PROPERTYTAXti <br />"�a � 5 �r�(� '�"1��,� S'C.✓ ,�,��(�' <br />� /' 7 -- <br />LEGAL for new construction: ShoR PlaUsubdivision � Lot No. (attach copy of long legal description) <br />OWNER � ���J� Phone/E-mail <br />Address � � �� � � � � � S �� City/State/Zip � �<<�'� � 7,� ? CG 3 <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor�S A9BIlf _ TBflBflt (must provide a letler of consent from the owner to do work in the space) <br />� <br />CONTRACTOR � `Z (U 1 � L �� t�� ��� `� � ���0y State Lic. # L Q � / {� r � 7 ��ity Bus. Lic. # <br />Address �L�(�t Gl S� /�(,�1��t�j'; /( �� �I -�1.� Phone/Email �ZI`- 7j�Y - �f �'� 4- <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />�on�el�- ail �� �l! lf YJ�Y� �' <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas_ Electric Other_ <br />t3uilding type: __ Single Family _^ Duplex �Townhouse _ Multi-Family ___ Commercial <br />Type of project: �'�'ew Addition Rei�odel Repair T I. Sign _ Sprinl<ler Demolition Change of Use <br />_ —_ .—_�._ --._ _ �._ . _ <br />DESCRIPTION OF WORK (additional space provided on the hack): <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New_Addn _Alterationf�-Repair <br />Show Number (#) of fxiures <br />A/C – air handling units <br />Forced air svstems <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas range <br />Clothes dryer <br />—� Range hood <br />—� Exhaustfan <br />Heat um <br />Unit heater <br />Boiler <br />Refrigeration <br />� Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/e <br />Backflow qreventer <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 lhe same to be lrue and correct. All provisions of laws and ordinances governing lhis Iype of work will be compl <br />with whether specified herein or not. The granting of a permit does not presume to give authonty to violate or cancel (he provision of any other state or local law regulating construction <br />That I am a�hbrized t�er of t pro erty to perform the work forwhich applicalion is made and I comply wilh the Slate Contractors Law 18.27 RCW and 296.200A WAC. <br />�( / <br />Owne Authorized Agent Signature Date (Revised 9/2014) <br />