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�ERMIT APPLICATI� <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: PROPERTY TAX # PERMI # <br />ic�is �s-� s+r-w� Sw,�V�,�r-�f�, w� Z�o4��0o io�ioo t� ���;i -��G �� <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER sa, �� p�Q�l(�'✓1 Phone/E-mail ��iD� ��i — 87�� <br />Address � �� � �L�� � � Ql ���' � � � � � City/State/Zip � � �'^%�--� r �- , �,�� � �j � �p g <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor'S A98111 _ T8(18�1 (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR � M S �j�l�� GY1 L& I Lic. # JMS COL I S � S COE Bus. Lic. # O2S�]D� <br />Address gcJ7cj �I II��,('�J 1��� �� �Q�rV�11..1i1 � w� Phone/Email (�2s) �3 ��� � <br />TENANT BUSINESS NAME CO TACT FOR PERMIT <br />Z.iTT-.e.�.�.h �c�,� T� 6-�--f u�-e, �� I I��r� bIo—'��' <br />Phone/E-mail f�.-�YP 1 YEJ�I�IXO'�Q.(�VI1��IQi11� • �OY!' <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � <br />Existing Use of Building � I i1Zi Gt HEAT SOURCE: <br />Proposed Use of Building Q (_,Q_ �A (M�i ��LC�IdY� 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) : ��� p _e �� Q� ��S_ /� <br />T-e,v�.ew�- h V��.��1Q,vJ� ✓��-wt.o c� e� ��c,t,�. c�� rr <br />OLc�c.c��'-e_2� r��l�-+� i ►'t �'(� ✓lOY � �cc�rf O'� � � <br />d��t ' c� cc� c.�.�it Gl Ciu-c r� � LR.�! o�-� I�L �� . <br />MECHANICAL PERMIT APPLICATION 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 />Forced air systems Bathtub <br />Gas piping Lavatory (wash basin) <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />j Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Kitchen sink & dis <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/barh <br />Urinal <br />Drinking Fountain <br />Floor drain <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 other state or local law regulating construction <br />That I am authorized 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 />�- <br />L l�� <br />Own uth ized ent Signature Date (Revised 6/2012) <br />