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• <br />• <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: ��I� � U� 7� (�� S� �vf�C� �f��f�PROPERTY TAX 4t <br />EGAL for new construction: Short PlaVsubdivision <br />� W N E R ��:V .,� d•� �,JrL �� 1�-�n,�1-�c.l� � <br />ress <br />APPLICANT: _ Owner _ Owner's Agent � Contractor <br />CONTRACTOR ��Z/ -->>r �� C.O•�S{�rµttic -� <br />Address ( Ci>V ��,,J �"1�" �, �,,,., �t K <br />TENANT BUSINESS NAME <br />BUILDING PERMIT APPLICATION <br /># � <br />`�:-- � J I', <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail L.ji.-S� 3vSj '� <-�� <br />ICity/State/Zip <br />_ Contractor�S A98flt _ T2f18l1t (must provide a letter of consent from the owner to do work in the space) <br />State Lic. #��r'���1<���� ��%.�' City Bus. Lic. # <br />r. / )` uv <br />��^�C �- � � �JS� Phone/Email �-lZ 5 �j� U L � <br />CONTACT FOR PERMIT ; ^ <br />�"`..tr�:-i ���.�� �^+. <br />Phone/E-mail � ''� �' `"� Ki� �i�� � t. <br />CONTRACT PRICE OF WORK ' i�S ; p�i �, �� <br />Existing Use of Building t���^=�•--��� <br />Proposed Use of Building �lou�5� `7 Gas <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel � Repair _ T.I. _ Sign _Sprinkler _De <br />DESCRIPTION OF WORK (additional space provided on the back) : ,-, <br />�� rP �.�� ��nc�. j �� �� �> �-� � � <br />MECHANICAL PERMIT APPLICATION <br />Type 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 />i Water heater <br />Gas fireplace <br />I Gas range <br />; Clothes dryer <br />Range hood <br />� Exhaust fan <br />( Heat pump <br />; Unit heater <br />Boiler <br />j rtetngeraUon <br />Woodstove <br />Ducting <br />j Other <br />PRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />Electric�_ Other <br />molition Chanqe of Use <br />-11U�`, �;- f;z"�s�, <br />;'��'i, t��� I�:��c:'�� (���1. , �_. <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />i Toilet <br />� Bathtub <br />I Lavatorv (wash basinl <br />K.itchen sink & disp <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <br />Urinal <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 lype of work will be complied <br />with whether specified herein or not. The granting of a permil 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 �au �zed by the owner oi this property to pertorm the work for which applicalion ' made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />/ !" �r------_' <br />�' � Z ��� <br />� <br />Owner/Authorized Agent Signature Date (Revised 3/2013) <br />