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• <br />C� <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 />ADDRESS: � � � � � ��m r ( �' /� <br />V <br />LEGAL for new construction: Short PlaUsubdivision <br />OWNER � I'FIII W � /�/ l� �Y <br />Address �� 1 7 �1C..�� � y�s � , <br />APPLICANT: _ Owner � Owner's Agent _ Contractor _ <br />M 1 <br />CONTRACTOR �r � � � I�tIO(.!,$�.lFi$, ���- • �i <br />Address p2O �p �� I�J�{'dZ1: ���rtl VUV � � <br />TENANT BUSINESS NAME � <br />BUILDING PERMIT APPLICATION <br />PROPERTY TAX q P MIT # <br />� �7�(1� ` <br />Lot No. (attach copy of long legal description) <br />PhonelE-mail y�' (�J i — ��� 3 <br />� �� <br />�City/State/Zip �= Vl,"►2_Gir (�(/�- p�l <br />COIllf2CYOf�S AgBf1Y _ T011BI11 (must provide a letter of consent from the owner to do work in the space) <br />, � State Lic. # �O4��J13��( City Bus. Lic. # p�N�7WV' <br />w�- qy�� a, Phone/Email o�(,ip� 7pr.� � 7177 <br />CONTACT FOR PERMIT J � (�,�(�.NUu � <br />� A�I.Ib�iL�s ��7'��r �pL'I �`��� <br />PhonelE-mail �/a�: 3 S3 ` V ��� �--�'l�l , /►� <br />CONTRACT PRICE OF WORK �(� �V7�?T� <br />Existing Use of Building �h'�}i� �� � <br />Proposed Use of Building �J��'YlJ � <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler � <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />� G�o a ���Y V��t�i fi(�us� <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 />i Gas range <br />Clothes dryer <br />Ranae hood <br />Heat pump <br />Unit heater <br />Boiler <br />; Kerrigeration <br />Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION <br />Number of Heads <br />HEAT SOURCE: <br />_ Electric Other_ <br />olition Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show NumBer (#) of fixtures <br />� Toilet <br />! Bathtub <br />Shower <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/b� <br />Backflow prevei <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />al <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 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 by ihe o��of this propeRy to perform the work for which application is made and I comply with the State Contractors Law 18-27 RCW and 296.200A WAC. <br />�.� �-� -�3 <br />Agen i�ture Date <br />(Revised 3/2013) <br />