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PERMIT APPLiCAT'�(�N <br />�UILDING/MEGHANICAL/PLUMBING/SIGN/SPRIRlKL�RIDEMOLITION <br />CITY OF EVERETT PERMIT ��RVICE� <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />SITE ADDRESS: v� ,�1�/ �/ Sf C' <br />% c0 c� <br />LEGAL for new construction: Short Plat/subdivision <br />jdress ���1� tV���'� f~II �'� <br />PPLICANT: �Owner _ Owner's Agent _ Contractor <br />ONTRACTOR J VV Y, � 1� <br />idress <br />:NANT BU5INESS NAME <br />BUILDING PERMIT APPLICATION <br />PROPERTY TAX €# <br />Lot No. (attach copy of long legal description) <br />f Phone/E-mail �20��> ZS S" f l i� Z�y� • 7� �� <br />r �}a �� 5 <br />City/State/Zip G Ve��� i w� /O 2�� <br />COf1ff8CfOf�S A9EIlf _ T2f18f71 (must provide a letter of consenl from ihe owner fo do work in ihe space) <br />State Lic. # <br />Phone/Email <br />CONTACT FOR PERMIT <br />Phone/E-mail <br />CONTRACT PRICE OF WORK <br />Bus. Lic. # <br />�'J.�i��-� <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas %� Eiectric_ 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,(' V1U►'nC (J1F-F�i' �ire y ��-ShDr.� �1G�YLQ � �IV,ir1� G�J✓1C�r�r'�Ov1.S`. <br />5e� � Ic1�s �vr ��1� f �c�i �s . /U o e��%/o��s �_ i—� Y'� � a.f1�i �;�G� � � - �� <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />fype of Project: _New _Addn _Alteration �Repair pe of Project: _New _Addn _Alteration Repair <br />Show Number (#) of fixtures Show Number (#) of fixfures <br />� A/C – air handling units 'z � Toilet <br />/� Forced air systems � � Bathtub <br />/ � Gas piping � Lavatory (wash basin) <br />j �_ Water heater � Shower <br />� T Gas fireplace � � Kitchen sink & disposal <br />O � Gas range % �, Dishwasher <br />� `Clothes dryer j Clothes washer <br />/ j Raqge hood ' ter heater <br />�_ Exhaust fan � �Sink (service/bar/mop/etc.) <br />— � Heat pLmp <br />/ � Unit heat�r <br />� Boiler <br />-- � Refrigeration <br />— Woodstove <br />— Ducting <br />� Other <br />SPRINKLER / SUPPRESSION�YSTEM <br />Number of Heads <br />Urin�{� <br />Drinkin ountain <br />Floor drai <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 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 properiy to perform the work for which application is made and I comply wilh the State CoMractors Law 18.27 RCW and 296200A WAC. 1� <br />1, <br />