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� � <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBI�i�/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 />ADDR�S,S; PROPERTY TAX # PERMIT #; <br />i Si- <br />, l � I �- � �fi � �f �:��-'�� <br />EGAL for new construction: Short PlaUsubdivision <br />ER � � ��'l IC Pi� � z" � <br />�S , � u }��C I �'I� i� <br />.ICANT: � OJ�ner _ Owner's Agent � <br />CONTRACTOR _�,�; /�J�.�C <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail ��(� In. �/nt; l`�' Fc� � I,r l t�' ��� <br />� <br />G <br />� CO�tfaCtOf _ C011tfaCtOf�S /aJ@Ilt _ T@IlBfli (must provide a let�ef of consent from the owner to do work in ihe space) <br />State Lic. # <br />City Bus. Lic. # <br />Address Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PEFiMIT <br />Phone/E-mai! t , i`�l (�.1,�, �t � ` � � � � �� ✓ � � / <br />BUILDING PERMIT APPLICATION CON�TRACT PRICE OF WORK � ,f �, r1C� � <br />Existing Use of Building (�C�F�� �'t +^� !�-,( l �''� j�j�N "� E`�,� HEAT SOURCE: <br />Prorosed Use of Building �--� � Gas Electric Other <br />� <br />Building type: � Single Family _ Dupl/ex _Townhouse _ Multi-Family _ Commercial <br />Type of project: Ne�v Addition '`/ Remodel Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK. (addi.rio�al �sace pr-vvided vn ihe back) : <br />� � M.�� �� �'� ��P ('� , � � � ' r� � S (i.�� r _-r-; c ��_-j � ��� �f-'�,SS � �� <br />MECHANICAL PERM6T APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� A/C - air handling units <br />� Forced air systems <br />Gas piping <br />. Water heater <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Unit heater <br />Boiler <br />; Woodstove <br />Ducting <br />� � Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type uf Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />I Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Sink (service/bar/m <br />Backflow preventer <br />Urinal <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 reatl and examined this application and know the same to be true anii r,�rrect. All provisions of laws and ordinances governing this type of work will be complied <br />wi?h whether specified he; ein 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 auttwrized by the owner of this property t�,rye�form the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />/ `- " �7/ ',� , �'1 � � �, ' � i ���..�, <br />�' � � � � / ! <br />Ow r/Authorized Agent Signatu�k Date (Revised 3/2013) <br />� <br />