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� <br />i <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SF'RINKLER/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: ., PROPERTY TAX ti <br />`7 � ; J `.:�� � e J L � ���J � C%� <br />PERMIT # <br />� <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER L i�/-�✓'K� '� � � _ - �- <br />1--� •,��L:.� c7 ��?'L,._ Phone/E-mail � ; ��- t� j � <br />Address ? ( j � �� �' . , j ',�.� City/5tate/Zip ��.N(:.�j� ,Q �%� �Q_� <br />APPLICANT: 1' Owner _ Owner's Agent _ Contractor _ Contractor�S Ag811t _ T@I10f11 (must provide a letter of consent (rom ihe owner to do work in ihe space) <br />ONTRACTOR i� i.� <br />idress <br />ENANT BUSINESS NAME <br />BUILDING PERMIT APPLICATION <br />State Lic. # <br />Phone/Email <br />Phone/E-mail <br />CONTRACT PRICE OF WORK <br />City Bus. Lic. # <br />Existing Use of Building 1�, 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) :/�,C�.J ;� i S�:w�S hL� ed. (�Ar`:�� �,-� �� �, Sk?�Sn� ,/��I,�c� <br />.�ti-��;L 'J�+"��Vc. J � +��- ����,"�;3r ��� � N`l.v�i! !'� :)���� r-� i�[kr,lc_ '� ,�, � �t;~�v . <br />MECHANICAL PERMIT APPLICATION <br />pe 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 />i Water heater <br />Gas fireplace <br />I Gas ranae <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeratior <br />Woodstove <br />SPRINKLER / SUPPRESSION S <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />pe of Project: X: New _Addn _Alteration _Repair <br />Show Num6er (#) of fixtures <br />� Toilet <br />I Bathtub <br />i Lavatorv (wash basin) <br />� Shower <br />t/ ; Kitchen sink & disposal <br />/ ; Dishwasher <br />Clothes washer <br />� Water heater <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 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 oiher state or local law regulating construction <br />That I am authorized by the owner of this property to pertorm the work for which application is made and I comply with the State Coniractors Law 18.27 RCW and 296.200A WAC. <br />��`r� � <br />Owner/Authorized Agent Signature Date (Revised 3/2013) <br />