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^ • • <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 vuww.everettwa.org <br />�i,�� � r�� -c�>�y 1 <br />SITE ADDRESS: PROPERTY TAX # PERMIT # � <br />; ,) .� � ; , _ _ � � <br />i- / i <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER 1�-�, Phone/E-mail l� l5 ��'/!� -�5 �u Z. <br />Address " � '� s� v� N� City/State/Zip � - t���- 7� <br />APPLICANT: �, Owner _ Owner's Agent _ Contractor _ Contractor�S A9@IlY _ T0f18f1t (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR State Lic. # Cit Bus. Lic. # <br />Address Phone/Email <br />TENANT BUSINESS NAME CO TACT FOR PERMIT '/ <br />/;J Z � � } � � _ � �-� � 1/ r'/t %�zK� <br />l`.� <br />Phone/E-mail /��J//1%/���i.4 ��t.% %-1<%i N1/�! L. C C� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building 5 7C°�s:/iC"rE HEAT SOURCE: <br />Proposed Use of Buiiding 5 i%-�/ 5��:�Ds�t�-c Gas_ Eiectric Other_ <br />Building type: �C Single Family _ Duplex _Townhouse _ Multi-Family _ Commerciai <br />T e of ro�ect: New Addition Remodel Re air T.I. Si n S rinkler Demolition Chan e of Use <br />DESCRIPTION OF WORK (additional space provided on the back): � <br />��"�� " �jvi ,�L' .�c%c"iC�O•/7 %`�i"/31-'i/l.%Cr 1=.'%�LLS B/.+L.l.� <br />p e�mO t,,, pr �-L s <br />br�5 c�� fi�-�-�,�� �Q��o (��do sP�p��S� c�'rP P��n�glN� <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair Type of Project: _New_Addn �Alteration �Repair <br />Show Number # of fixtures � Show Number # of fixtures <br />A/C - air handlin units Toilet <br />Forced air s stems Bathtub <br />Gas i in Lavato wash basin <br />Water heater Shower <br />Gas fire lace Kitchen sink & dis o <br />Gas ran e ,f Dishwasher <br />Clothes d er Clothes wash <br />Ran e. ood Water hea <br />Ex �ust fan Sink s ice/bar/mo /etc. <br />eat um Bac ow reventer inside bid <br />Unit heater inal <br />Boiler Drinkin Fountain <br />Refri eration Floor drain <br />Woodstove Grease tra <br />Ductin Roof drains <br />Other Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM Other: <br />Number of Heads Other: <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 compl <br />with whether specified herein or not. The granting of a permit does not presume to give authority lo violate or cancel the provision of any other state or local law regulating construction <br />That I am authorized by the owner of this properiy to pertorm the work forwhich application is made and I comply wilh the State Contractors �aw 1827 RCW and 296.200A WAC. , <br />i` <br />� <br />/ � j,' �L `�/ r/! 5 - . Z <br />O'ner/ �uthorized Agent Signature Date (Revised 4/2015) <br />