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• • <br />PERMIT APPLICATION <br />BUILDItVG/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.everetiv✓a.org <br />SITE DDRESS: PROPERTY TAX # PF,�MjT�� �/��_� <br />% �� �l �� S l,�.a �'� <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER �� �X.rL � CCr�G� ������ Phone/E-mail��'���-��>J� ��Ltd��v������� � COG��C �'S� <br />G,. <br />City/State/Zip <br />APPLICANT: � Owner _ Owner's Agent _ Contractor _ Contractor�5 A9811f _ TEflBfit (must provide a letter of consenl from the owner to do work in ihe space) <br />CONTRACTOR �'W �`�/d State Lic. # City Bus. Lic. # <br />Address Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />Phone/E-mail �� �vt.t,,, <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building ,')� C.S+ G1�'i� Z <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ <br />Type of project: New Addition Remodel Repair <br />DESCRIPTION OF WQF?K (additional space pr vided on the back) : <br />����aC -r �7�l5����1��( ��C.� - �%"i h'�� �{� <br />J <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I A/C - air handling units <br />� Forced air systems <br />� Gas piping <br />i Water heater <br />i Gas fireplace <br />i Gas range <br />! Clothes dryer <br />( Range hood <br />( Exhaust fan <br />Heat pump <br />� Unit heater <br />Boiler <br />i Refrigeration <br />j Woodstove <br />I Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />HEAT SOURCE: <br />Electric Other <br />Multi-Family _ Commercial <br />T.I. _ Sign _Sprinkler_Demolition Change of Use <br />�-G� Cc��� �, c�� b'��r rl i ati'l(.i. G')'L , <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />+ Toilet <br />� Bathtub <br />� Lavatory (wash basin) <br />j Shower <br />! Kitchen sink & disposal <br />i Dishwasher <br />i Clothes washer <br />; Water heater <br />i Sink (service/bar/mop/etc.) <br />� Backflow preventer <br />I Urinal <br />i Drinking Fountain <br />� Floor drain <br />� Grease trap <br />I Roof drains <br />j Medical Gas <br />� Other: <br />I <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 other state or local law regulating construction <br />That I am� uthorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />-, �% �. ,�', �'�z <br />✓;, , �" �� <br />O er/Au orized Agent Signature Date (Revised 3/2013) <br />