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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 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: PROPERTY TAX # PERMIT # <br />l � �� i `' Z z °��'?i%� % .i `i S' .33 � r�/7l� � �C:�� - ' �' � <br />LEGAL for new construction: Short PlaUsubdi�ision Lot No. (attach copy of long legal description) <br />° 7s�=7 L `�y�,.I ) <br />OWNER y�. . �i / 'r� � " i-� � L-G,. Phone/E-mail � • G/7 /f'L e..�. g�� ..c�� _ � C'' • >>��+—� 'r}S� . �1.� � <br />Address ,�� Z.- j�,� ., l' '� /�,',.r City/State/Zip l� C'� °J� i J �� .', i c L�, F-� �" d U,'� <br />APPLICANT: � Owner _ Owner's Agent _ Contractor _ Contractor�S A90flt _ T2f12f1t (must provide a letter of consent from the ovmer to do work in the space) <br />CONTRACTOR �i %� /� �� ,�; .<" L , L L L& I Lic. #� j j�G ! f3��C;j i.�; COE Bus. Lic. # <br />Address �i�Z /�,` j� c�� G� Phone/Email �C"GK/�'�ciY.i,�i� � l� �i�s. o... <br />TENANT BUSINESS NAME CONTACT FOR PERMIT G <br />�%Y�,l+c� i �75''IG�- `s�/"%L% <br />Phone/E-mail �i;'� � L-%:�c [,Ci � G".�,'oi�' �-T�� c'/� 1. G�°--- <br />r <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building u- � � HEAT SOURCE: <br />Proposed Use of Building �,�i l�'�l- � r� Gas_ Electric Other <br />Building type: _ Single Family � Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�I ;,-� ), i ' � %�c;i�iL � �'"L�`c 1 SZ1GP'�L �J��iL; <br />�- i i �� 1!'L- ��6 L'r'���� ijv t`� �_ �;!Lr "� / <br />✓ GZ' �i,`yl'"G /�7:�i% %�L � i l����i j�. ,�-'���7t;..i�-G � 1-i L�`'/!�,L; �%���)�'���� �"5� <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 �xtures <br />j A/C — air handling units � � Toilet <br />j Forced air s stems I, Bathtub <br />� Gas piping ;7 Lavatory (wash basin) <br />j Water heater � Shower <br />Gas fireplace ; Kitchen sink & disposal <br />� Gas range I Dishwasher <br />' Clothes dryer ' Clothes washer <br />, Range hood �. ' Water heater <br />' Exhaust fan i Sink (service/bar/mop/etc.) <br />I� Heat pump I Backflow preventer <br />� Unit heater � Urinal <br />Boiler ! Drinking Fountain <br />; Refri eration ; Floor drain <br />� Woodstove i Grease trap <br />� Ductin � Roof drains <br />j Other i Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM � Other. �4:JG .,i�Lr %�z_ l,-,u��i �� <br />i Number of Heads � ' Other. ��;!-iT4;�C.- L-i,it;'f-� <br />I hereby certify thal I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this type of work will be complied <br />with whether specifed herein or not. The granting of a permit does nol presume to give authonty lo violate or cancel the provision of any other state or local law regulating consWction <br />That I am authonzed b�f owner of lhis property lo perfomi the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. <br />i � ''� - <br />� -- , -� _ - <br />�, i,� .;,�ii' <br />'� OwnerlA�ttho ed A t ignature Date (Revised 6/2012) ;/ <br />/� <br />