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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 />PROPERTY TAX # <br />� <br />P�R l �I I c� `o%� <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />ress <br />Phone/E-mail <br />City/State/Zip <br />APPLICANT: _ Owner _ Owner's Agent Contractor _ Contractor's Agent _ Tenant �m�5t P�o��de a iene� or �o�5e�c r�om �ne oWr,e� ro do Wo�k m me SPa�e� <br />CONTRACTOR ; `i �� �C" <br />�` -\'^ tate ic. # L.V�,` \;� ;�{�{LL City Bus. Lic. # <br />Address Z:� � \\ �� � �' ��elEmail 2?) � - ��� � � <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />�'Yt.> �� f�7. l �r-1 <br />,'�1 G�� ���� �� 1�1C��1 l,l�cc._.'� � ,� `�1CC?� �,t�l� � �'1cC�'11 <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK� (� �`�;. — <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ <br />Type of project: New Addition Remodel Repair <br />DESCRIPTION OF WORK (additiona/ space provided on the back) : <br />f �<� C i� i'I�C�G�, <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Num6er (#) of fixtures <br />A/C — air handlin units <br />Forced air s stems <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes d er <br />Ran e hood <br />Exhaustfan <br />Heat um <br />Unit heater <br />Boiler <br />Kerrigeration <br />Woodstove <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Multi-Family _ Commercial <br />T.I. Siqn Sprinkler <br />HEATSOURCE: <br />Electric Other <br />�molition Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixiures <br />Toilet <br />Bathtub <br />Lavatory (wash basin <br />Shower <br />Kitchen sink & dispo: <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/moF <br />Backflow preventer <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 comp <br />with whether specifed 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 am authorized by the owner of lhis 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 />i i� f <br />;-�, �� � �� ti� ; - .._ y <br />wner uthonzed Agent ignature Date (Revised 9/2014) <br />