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• • <br />PERMIT APPLICATION <br />BUILDIIVG/IVIECHANICAL/PLUMBIIVG/SIGfV/SPRINKLER/DEiViOLITION <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: ^ <br />� � � '�� �-Fk �: <br />LEGAL for new construction: Short PlaUsubdivisi <br />OWNER � �'� <br />i <br />Address <br />APPLICANT: � Owner <br />CONTRACTOR � <br />Address ����{� - �.� <br />TENANT BUSINESS I <br />Owner's Agent _ Contractor <br />�zr I � <br />BUILDINC PERMIT APPL.ICATION <br />d <br />PROPERTY TAX # <br /># <br />No. (attach copy of long legal description) <br />Phone/E-mail �-�J,\�- <br />ICity/State/Zip <br />Contractor�5 /�g8�t _ TBf1811t (must provide a let�er of consent from lhe owner �o do work in Ihe space) <br />State Lic. # ' City Bus. Lic. #� <br />I� 11�-�� Phone/Email � �` •-- �-��. <br />CONTACT FOR PERMIT <br />Phone/E-mail <br />CONTRACT PRICE OF WORK `� 2.,O"v' v� u 1� <br />Existing Use of Building 1��+,I HEAT SOURCE: <br />Proposed Use of Building Gas Electric Other <br />Building type: �C Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New _ Addition Remodel Repair r� T.I. _ Sign _Sprinkler _Demolition Change of Use <br />d��: ���;�:aiaTA(.3�1 C)F ��lC,;k�a"„ (additional spece provided on fha barlcl : <br />�� i���l���- � ��-�«�� ��,p�s,-� ��s-k �i� I��oS�.rn:�r�- u�t� �x� ��s�fi <br />� <br />. <br />� 1��1r- �y �t� t� -'�� '�'u� �1�;:-z. c�l���r�' �'�+ �i�� 5 � ��t,u.- <br />� F-���t;� t�-cc.t � , iewt��.�t�'4i�;����1�;.t, <br />MECHANICAL PERMIT APPLICA'T10 PLUMBING PERMIT APPLICATION <br />pe 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 />Gas fireplace <br />Gas range <br />� Clothes dryer <br />j Range hood <br />� Exhaust fan <br />� Heat pump <br />Unit heater <br />' Boiler <br />� Refrigeration <br />Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />i Shower <br />' Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />' Water heater <br />; Sink (service/bar/mop/etc.) <br />Backflow preventer <br />' Urinal <br />Drinking Fountain <br />! Floor drain <br />I Grease trap <br />Roof drains <br />i Medical Gas <br />i 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 />wit he r specifled 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 />T t I am a horizec�by,th ov�n of this property to perform the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. <br />/ f` � <br />J� � r- -1 �, . <br />Owner/Authoriz� Agent Signature Date (Revised 3/2013) <br />