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�� <br />�ERMIT APPLICATI <br />O <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 ADDRI <br />%� � <br />LEGAL for new cc <br />OWNER �{.,, <br />ERTY TAX it <br />0 <br />�� <br />Short Plat/subdivision Lot No. (attach copy of long legal description) <br />? i� V V Phone/E-maii `I 2�—� I� 5�, � <br />Address v �'`� � `� �� �� City/State/Zip � �/ �/� w � � Z� � � <br />APPLICANT: _ Owner _ Owner's Agent . Contractor _ Contractor�S AgBflt _ T@fl8flt (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR � � L� �/� � State Lic. #��1� ��?�1 g City Bus. Lic. # p-rjZ��D <br />Addressllll� 22 b�'�` S�' SW i� � �{,y� }�� �Q�U� hone/Email 2S' t 1 �—�� 3� <br />TENANT BUSINESS NAME CO�ITACT FOR PERMIT 2� ZS-11 �.� 13 G <br />v .. . l 1 <br />BUILDING PERMIT APPLICATION <br />Gl Y�G� Wl b �1.1 <br />ail l 1�1T�1 i� � �����Q �L CiJ /VtfO✓�'i' - L <br />CT PRICE OF WORK `P Z�I �D <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: �Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Tvoe of oroiect: New Addition Remodei Reoair T.I. Sian Sorinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />S`i� - gU �� �►-�u c e G 1,�� e o�-h� <br />MECHANICAL PERMIT APPLICATION <br />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 drver <br />Exhaustfan <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 />HEAT SOURCE: <br />Gas Electric Other <br />Demolition Chanae of <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer (inside <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <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 will be comp <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 />T at I am authorl d by the owner of this property to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />_ a�fnS<<� '��p�j��'� <br />Owner/Authorized Agent Si n ure Date (Revised 4/2015) <br />