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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 />SITE ADDRESS: ' 1 � PROPERTY TAX # �RMIT <br />�7C�'(�- %��Y��'�_ �!lu�: �����_��_�( L�il� /�4�� � 1Jf���" <br />� <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />r" / <br />OWNER : ��� t �'�_ L C� �„i Phone/E-mail �% `� �1 `%�+ � �',� <br />Addfess / f � l /-� � ��- �,, �'' ,. > ' � ���/� �%'0 �G'l <br />L�- /% ��� ll Glc' � ���_�Li�' / �J , i ��' �' City/State/ZiP i.���l�,;P�c_ . <br />PPLICANT: ,'� Owner _ Owner's Agent _ Contractor _ Contractor's Agent <br />NTRACTOR !�r.! : , ic%. � <br />Address � _� Ck i � � �= ? <br />TENANT BUSINESS NAME <br />State Lic. # <br />� <br />TBf18f71 (must provide a le�ter of consent from the owner to do work in the space) <br />Phone/Email <br />BUS. �IC. $� <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building .ii /i�� �e -��ii/i ��y HEAT SOURCE: <br />Proposed Use of Building 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 />f � y /� 1 / i �{ <br />,�C`i)1ii/[ �G�/1 a� /'Lii�v-rL� S //uc'/Ct� `-- !�"r '✓ �,✓?..' Cy! d/i C / �G'iJ� �%//�/i c:�J�.� ,�;L��. <br />l <br />'_,, ;j7�/�<<-��=�„' <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />I A/C - air handling units <br />� Forced air systems <br />Gas piping <br />Water heater <br />i Gas fireplace <br />i Gas range <br />j Clothes dryer <br />� Range hood <br />� Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />� Refrigeration <br />� Woodstove <br />I Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Numder (#) of fixtures <br />Toilet <br />Bathtub <br />j Lavatory (wash basin) <br />i Shower <br />Kitchen sink & disposal <br />Dishwasher <br />j Clothes washer <br />j Water heater <br />I Sink (service/bar/mop/etc.) <br />I Backflow preventer <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined this appiication 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 propeRy to pertorm the work for which application is made and I comply with the State Contractors Law 16.27 RCW and 296.200A WAC. <br />j�� C / : � � � � � /C> � � 1ti ��' , <br />Ownea/ utho ized Agent, ignature Date (Revised 3/2013) <br />