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• • <br />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 />ADDRESS: ' <br />�Zo �G'� � S) Sl:..; <br />RTY TAX q <br />c� <br />� � — � � �{;, <br />AL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />JER �� ) h�' :r ) S s!�1'Z 1 � TI Phone/E-mail ''% [.j —,� � L .. L� t�1�� �_ <br />ress � � SC iti'�l ��a <br />APPLICANT: _ Owner _ Owner's Agent <br />City/State/Zip � v �✓L' �, �� -} � I�� Z,;` � <br />ctor _ Contractor�S Ag2flt _ T8f18f1� (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR � ,l�-1,� �,.> ��'�� �(,�-,(���� } �� ;�,�'_��`�a� tate Lic. # �-ilj;=}�v " °13i �; City Bus. Lic. # <br />Z �; � , ,,- , � a �-_ c --,c � <br />Address )� � "s o�� -�� 1�,��-��� ��Z �,,-. "� 4v� ��j -,:-�� � Phone/Email '��� �� � l� - % �%) � <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />Phone/E-mail �`� C ) - •,Z`') 3 %�� I.� <br />BUILDING PERMIT APPLICATION COiVTRACT PRICE OF WORK �� cc�� ` <br />Existing Use of Building 5� N � G= -_.#, ti� �' �4-� �;).- ��� i= HEAT SOURCE: <br />Proposed Use of Building S, w' � L%' �'��°�1L`/ ��-�s���'..�. '• Gas <br />Building type: �Single Famfly _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler _Demolit <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�� � D► �U b �l ) w���� ,��.�, L 1�,r e r�� S� N v �`�=slZ � r9 ��, ►J i� N� w`�};;,-� <br />� <br />�(i'_�_;'�.� �i , rv b � � .�- > > T1 a ►v � � �l �s� ; �.� f ,�►� �. ��cr,� ,� r L. � v � rvb �/Lt�7,r� <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 />; Gas piping <br />� Water heater <br />Gas range <br />Clothes drye <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refriaeration <br />Other <br />of Use <br />J'✓'�.:.1`'� o V+ rv'�y r�+2� ;(,'� (�=� <br />PLU�VIBING PERMIT APPLICATION <br />Type of Project: _New _Addn �Alteration �Repair <br />Show Number (#) of fixtures <br />� Toilet <br />Bathtub <br />i Lavatory (wash basin) <br />. i Shower <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/ <br />Backflow preventE <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />j Other i Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM Other: <br />Number of Heads Other: y(��C,a,�t E S V� � <br />� <br />I hereby certify that I have r�ad and ex�mined 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 cr nof. 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 ihe oWner of this property to perform the work for which appiication is made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. <br />� �� <br />� �-.' '�--�--- �3�� / <br />-; <br />0 r�n,�r/Aut " riz Agent Signature Date (Revised 3/2013) <br />