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� <br />� • <br />PERMIT APPLIC��ION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />32U0 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />SITE ADDRESS: Li �i �_,1 �+\`1 t� i �� <br />LEGAL for new construction: Short PlaUsubdivision !�^ �'T--r�^ <br />OWNER �'�fc�� � iir_���c•_ �n�v'.. <br />PROPERTY TAX fi P RMIT <br />Q����i�V Lo�����iicj 1� I a��-Z%f <br />���- Lot No.�_ (attach copy of long legal description) <br />� � .-, � � . � <br />Phone/E-maii � �,j '�1.7 lJ �`7`S_S / c� 'r' "�l. .��`> �c� <br />Address � 1 c1 �� `,•� .l ,� ` j �_ ICity/State/ZiP � \/c.,r� k—�' � �- ��- i �� �S C.�=''S <br />APPLICANT: _ Owner _ Owner's Agent � Contractor _ Contractor�S A9@fli _ T011af1t (must provide a letter of consent from Ihe owner �o do work in the space) <br />CONTRACTOR `,��,�,n (': ; . ti�v� ' jV i �-(•� .; � � State Lic. # '�c r��; ; �`5 % � �` City Bus. Lic. # (.� ��J (._j_ �� <br />Address �� r] �`p �� �� � 5�1- ��t� 5 ��. jZ-- �� Phone/Email �� �� �� ( S �� � l �� <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />, {�C��e� _ �- J , ��v� S �-u • � <br />r ' �- �t <br />�; <br />' Phone/E-mail �j ZS �f l � �3� I CJ �� J c. `H r. ;, �i,> �� �J IU��, :<<-,� <br />BUILDIWG P��MIT APPLICl�►TION CONTRACT PRICE OF WORK <br />Existing Use of Building ``�-i , �� :�<` -�'' � -� � <br />Proposed Use of Building ;f� '`� �"' i' `• i G= <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New _ Addition '� Remodel � Repair _ T.I. _ Sign _Sprinkler _[ <br />DESCRIPTION OF WORK (additional space provided��on �the back) :y�. <br />i - �.Si����� .., . �v`..Jg:-4�— ....f `1�l t<=�C�i•l �v��-\.-r5.�'�Ci <br />I� , , I� , <br />MECHANICAL PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Numder (#) of fixtures <br />j A/C - air handling units <br />i Forced air svstems <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 />Woodstove <br />Ducting <br />� Other <br />PRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: %�.�'� <br />_ Electric_ Other_ <br />olition Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _kew _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />! Bathtub <br />i Lavatory (wash basin) <br />i Shower <br />; Kitchen sink & disposal <br />; Dishwasher <br />i Clothes washer <br />Water heater <br />; Sink (service/bar/mop/etc.) <br />Backflow nreventer <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 authonzed by the owner of this properiy 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 />,� �,1 � ���, <br />Owner/Authorized Ag�nt Sign}4ture <br />Date <br />(Revised 3/2013) <br />�t <br />�, : ,; � <br />C. � - <br />