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• • <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRIN KLER/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 AD3DR,ESS;.-r .� ��r PROPERTY TAX p P RMIT # <br />.—� 1., i � — ���� � �� �' ot �<=1 l�Jt���C"1`�4�'f�s � i �r"�C�—rf <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER \�� <{- j.,� �� . � jy,� yy�„y ��G,c Phone/E-mail L' J j I� �j ��L `� <br />Address �� j ��3 ° � �� � 'w City/State/Zip :-��y� � � �r'� �' Z�i � <br />APPLICANT: _ Owner _ Owner's Agent � Contractor _ Contractor'S A9@flt _ TBflBflt (must provide a letler of consent from the owner to do work in the space) <br />CONTRACTOR ��'�;,���n '� � �� � ` i.� L & I Lic. # �l�r'rrr 1 �tJ Gu� �j COE Bus. Lic. # �3��r_` <br />4ddress c��1t�>�� �`''J�� j�te}� � �ti i: �r'� ���'�(J�y1 Phone/Email � � ��% �,[� <br />TENANT BUSINESS NAME CONTACT FOR PERMIT � <br />�ti; i l� l� 1��� IL- <br />Phone/E-mail �` �: � C C�`�� S�(��� i"i�l�� 1�,: t�-�_� `� �f ��� <br />.r t �P.w(. <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building � 6`6`" <br />Proposed Use of Building ��" � 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 dd't' I d <br />HEAT SOURCE: <br />Electri <br />ition Chanqe of Use <br />(a r �ona space provi ed on the back) . <br />i � <br />L�,,��-�'��fi �a�11��'.��+-r.�� c4,.��','tc.�.. �;>r�-ti' L.�.. �v�r �is�"In� c�ICi�IS- ,��(,? X I� <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Clothes� er <br />Range hoo <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />Other <br />SPRINKLER / SUPPRESS <br />Number of Heads <br />TEM <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />�nower <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Drinking Fc?a <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />basin <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 />' ��.� � k��, � � i� � � <br />O er�Authorized Agent Signature ate (Revised 6/2012) <br />