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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: �, e L I L/� � PROPERTY TAX # PERMIT # <br />( ( �Q,/`�- � �J � � !�D <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER Cth �,�„� GC��--LC� PhonelE-mail L/2S' �Sv � z 6 <br />Address l(.� Z� L.i C� f/�U R,� City/State/Zip � Z� <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor�5 A(JBfll _ T@f1af1Y (must provide a letter of consent irom the owner to do work in the space) <br />CONTRACTOR ��� G�''l�^'"'�� State Lic. #�k�G�'GI �IZ�IU S City Bus. Lic. # <br />Address r V w � G�`��u !i �� Phone/Email `�i� 75d ��Z� <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />ri1�1W �u'� �� � Phone/E-mail � ��� 7/ v �� �� <br />�_ <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK `�-5��0 <br />Existing Use of Building ✓� �t,� , HEAT SOURCE: <br />r <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 />��:.. � � ����� w �-,.,�-. ,s7 ��- �/� w-,�,� Cj����,��� � �3 �i <br />,�'c._ .�% I.� � � S -�'u�S ' -� vt,2- v J/-z- � � �.1 �.r� `�a,�,,�5 /„� 2 � (�lf'1 <br />MECHANICAL PERMIT PPLI ATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair Type of Project: _New �'Addn �Alteration �Repair <br />Show Number (#) of fixtures Show Number (#) of fixtures <br />A/C — air handling units �_ � { Toilet <br />I Forced air systems � � Bathtub <br />j Gas piping 2_ i Lavatory (wash basin) <br />j Water heater j Shower <br />Gas fireplace / j Kitchen sink & disposal <br />i Gas range i Dishwasher <br />; Clothes dryer L ; Clothes washer <br />Range hood 2 ' Water heater <br />Exhaust fan ; Sink (s Fvice/bar/mop/etc.) <br />� Heat pump I Backflow preventer <br />i Unit heater Urinal <br />i Boiler Drinking Fountain <br />i Refrigeration j Floor drain <br />! Woodstove I, Grease trap <br />Ducting i Roof drains <br />� Other � Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM I Other:. <br />Number of Heads I 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 o this pr erty to pertorm the work fo� which applicalion is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />�---- i/z��� 3 <br />Owner/Authoriz Ag nt Signatu e Date (Revised 3/2013) <br />