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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 /> SITE ADDRESS: ( � J� heLlL�- PROPERTY TAX N 2��j?�Z�Ec'�?2Lg�% PE IT# <br /> t2`�G� �.�i'FfG ,- -4�cY �sz�-1� 2ad53o��r5"T2D( �31 Z � UZ� <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> C�F2y 2Sg�:8� <br /> OWNER ��{��'.7EE-6G�.�Z6�rlcs}�(a(r.�c:eX-(,. hone/E-mail �p� � ,�{� � � - <br /> Address ��j2[ �i(��`j`Z` ��[��. City/State/Zip C—YG-�T'�{� ��, ��2_.D� <br /> APPLICANT:_Owner �Owner's Agent _Contractor _Contractor�S A9Ef1� _TBI1811C(must provide a letler of consenl from ihe owner to do work in the space) <br /> CONTRACTOR�G�'ff�"�Y� �2�-�nl�L�-'k(.. ��. tate Lic.# City Bus. Lic. # <br /> Address (32.( G.�t.,�`Z' ��(�. Phone/Email ��,G���KY�SrKC-�:c�ch4d.� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT t--����� ��,Y�.� <br /> F't"'�C-S.11ta�fC� C�E'�y tbf�(�fi/�'C�=�st(.� ,s�=•�'= C�?S�'�-�•d8�8 <br /> �,•�^�:�c�.�-(j•�t-�(" �4�si �LSCY�c'�r�� Phone/E-mail �o�j r/��n�j�.t�'G�,�t"�'7 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ���,. O�. �t� <br /> Existing Use of Building M�71C'sS.L /_�_cE-1f ,� ��tfi>!�`�t�i-.L'f' HEAT SOURCE: <br /> ProposedUseofBuilding�-�7(G�.C�/t-chL(�' --aLi'G'Pa"CZ�4-4,�t^ Gas Electric_ Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family X Commercial <br /> Type of project: New _Addition Remodei Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> �n c�-�- �z�-�c.��x.c, � �a�--i �x c��t-1.�, ac.x-r���—rc�t-�c-r- �c�c c--c�c: ��� �ct�=�_t' <br /> �Ll�'2. -t�b A'C� �s t�-Cr�=sV�! GL(t-1(G:"CG-�1/�-C['. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Aiteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixfures <br /> A/C-air handling units � Toilet <br /> i Forced air systems ! Bathtub <br /> i Gas piping j Lavatory(wash basin) <br /> j Water heater j Shower <br /> Gas fireplace j Kitchen sink&disposal <br /> i Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> ! Range hood Water heater <br /> i Exhaust fan ; Sink(service/bar/mop/etc.) <br /> j Heat pump ', Backflow preventer <br /> � Unit heater Urinal <br /> ': Boiler Drinking Fountain <br /> ; Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> i Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads � Other: <br /> I hereby ceRify 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 the owner of this property to peAorm the work for which application is made and I comply with the State CoMractors Law 1827 RCW and 296200A WAC. <br /> �----- _.\ � <br /> r �F��1�' (� <br /> Owner/Authorized Agent Signa Date (Revised 3/2013) <br />