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P�MIT 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 425-257-8557 www.everettwa.org <br />SITE ADDRESS: , I,�l� ���� � <br />yi� <br />LEGAL for new construction: Short PlaUsubdivision <br />OWNER s,,��,n n� P <br />Address /��l-� �y?;�_�Q�(/'� �GLt� <br />APPLICANT: _ Owner _ Owner's Agent � Contractor <br />CONTRACTOR C m �QQ,�'I Y� �Y�.C. <br />Address ,��,� �r0���,� �'e.rL� <br />TENANT BUSINESS NAME <br />BUILDING PERMIT APPLICATION <br />PROPERTY TAX ti <br />PE��ITII#✓ 1 �� � O <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail ��� G�/� �0 v-/ <br />City/State/Zip �%�c�j � � �O µl <br />Contractor�5 Ag01lf _ T0l12f1t (must provlde a letter of consent from the owner lo do work in the space) <br />State Lic. #� ��`���� <br />� qg�� Phone/Emaii �� l, <br />CONTACT FOR PERMIT <br />��1n.�:e, �25 25Q 12b� <br />CONTRACT PRICE OF WORK <br />Existing Use of Building <br />Proposed Use of Building Ga <br />Building type: _ Single Family � Duplex _Townhouse _'Multi-Family _ Commercial <br />Type of project� New Addition Remodel Repair T I Siqn Sprinkler _ <br />DESCRIPTION OF WORK (additiona/ space provided on the back): <br />l v�5f�.�c- cL�cz�.�- ,-D�.Q-� �"�n,�"' <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handlin units <br />Forced air s stems <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes d er <br />Ran e hood <br />Exhaust fan <br />Heat um <br />Unit heater <br />Boiler <br />Refri eration <br />� Woodstove <br />Ductin <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />EAT SOUR <br />Demolition Change of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Num6er (#) of fixtures <br />h ba <br />Kitchen sink & dispa <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mc <br />Backflow preventer <br />Urinal <br />Drinkinq Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />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 wiil be compl <br />with whether specified herein or not. The granting of a permil does not presume to give authorfty to violate or cancel the provision of any other state or local Iaw regulating construction <br />That I am authorized by the owner of this property to perform the work for which application is made and I comply with the Stale Contractors Law 18.27 RCW and 296.200A WAC. <br />� � 20 •15 <br />Owner1 uthorized Agent gnature Date (Revised 92014) <br />