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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 />ITE ADDRESS: <br />�'1�:%1 �—�'�'i► <br />'ROPER TAX q <br />v �"t ' ""( ��C''C`a0 <br />P <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER�-'`LLY)1�C�-�-� �-� �'��: �-�ir'�u.L�-L�� Phone/E-mail �c'�.GlZ'..�--(��,1L, <br />Address 5�`�C� Gt.: t�'�( �����(',� 7� �� L City/State/Zip %�-'��L«-' i�-`�� '��-�1� <br />APPLICANT: _ Owner _ Owner's Agent � Contractor _ Contractor'S A92flt _ T@fl2fll (must provide a letler of consent from the owner to do work in the space) <br />CONTRACTOR ���C-��-% L��c7�ti��'�-' l�>'�L��L`� State Lic. # 4Lll`���L'� I`��' �1 City Bus. Lic. # L'��.� ��c� <br />�{--'�=��%�L�- i: ,`�G i� ✓j Lik�-ii`C�Gti� ��.�' Phone/Email�Z�. �-v1��(,Ch�C`.t'n,�rt�cC.:tze'L����C <br />Address <<iC'2- � � <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />��--�'�� ! V �� � <br />� <br />Phone/E-mail Z�:j�y: .:'�` �� —�'t�''' <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK `�`'S 'C��' <br />Existing Use of Building �' ��t�l�-'��� HEAT SOURCE: <br />Proposed Use of Building ��7ZliC1.' � l�t— ��6t,�` �� �Yr�'� �"L ��� Gas l� Electric Other <br />Building type: � Single Family _ Duplex _Townhouse _ Mu�ti-Family _ Commercial <br />Type of project: New Addition � Remodel Repair T.I. Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (addifional space provided on the back) : � <br />F��� i����'��tiL ��f�-��� -� tic: �`,,� f'��'�� t� �� �'7�- ��..�`f"ti ��.�-�: t.. t__� <br />r� inc°�r���c � c (Cs e1� �fi� ���r��' ���i���� �, <br />� <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C - air handling units <br />I Forced air systems <br />j Gas piping <br />Water heater <br />Gas fireplace <br />Clothes drye <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Type of Project: _New_Addn �Alteratior <br />Sirow Number (#) of fixtures <br />i Toilet <br />� Bathtub <br />� i Lavatory (wash basi <br />� j Shower <br />i Kitchen sink & dispc <br />j Dishwasher <br />' Clothes washer <br />Water heater <br />;' Sink (service/bar/mc <br />� Backflow preventer <br />Urinal <br />! Drinking Fountain <br />j j Floor drain <br />; Grease trap <br />Roof drains <br />j Medical Gas <br />; Other: <br />� Other: <br />_Repair <br />al <br />I hereby cerlify that I have read and examined this application and know lhe same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied <br />wi�h whether specified herein or not. The granting of a permit does not presume ro give authority to vioiate or cancel the provision of any other state or local taw regulating consfruction <br />7hat I am autharized by the owner of this propeRy to perform the work for which application is made and I comply with the State Contractors Law 18 27 RCW and 296200A WAC. � <br />C- . �� �2 � <br />� - � � � ►�z�,� <br />Owner/Autho � ed Agent Signature Date (Revised 3/2013) <br />