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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 />ADDRESS: <br />L for new co <br />'NER 'ri/�.� <br />ress C7C-}�%�� <br />'LICANT: _ Owner <br />PROPERTY TAX it PERMIT # <br />�Z �=�T��{ �c�� (`,&�J � 31( -� �D � <br />�� <br />on: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />� LLF ��' � Phone/E-mail 2� � - " �j 2 "` � ,=_> � <br />���j � City/State/Zip <br />Owner's Agent b Contractor _ Contractor�5 A j2flt _ T@Ila�l (must provide a letter of consent from the owner to do work in lhe space) <br />CONTRACTOR rV 1�,� {3�'L.L� ��"jC �� � State Lic. # City Bus. Lic. # <br />Address � L"��%�- G }�� � Phone/Email ����j'" � • �Z -- -� <br />TENANT BUSINESS NAME CONTACT FOR PERMIT ��-,�7,� L� r:.�� <br />Phone/E-mai��� '� ��'� "" � �� `� �`� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �� a�z� �%(C° <br />Existing Use of Building ������ N��'� ��p <br />Proposed Use of Building ��SiD' ►��i�-L 5 1—� <br />_� <br />HEAT SOURCE: <br />Building type: Single Famil _ Duplex _Townhouse Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repa_ i� T.I. Siqn Sprinkler Demolition <br />DESCRIPTION OF WORK (additional space provided on the bac � <br />�z�i�?,�. i � r�- �Z� � c�1��'� <br />I`'ll Nv►� A}�`fW�LL R�PL�e'��7-� <br />E.� � c_ r� t c� �,� L t-�i c rC �-:� r►�� <br />MECHANICAL PERMIT APPLICATION I— <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C - air handling units <br />( Forced air systems <br />j Gas piping <br />I Water heater <br />Gas fireplace <br />Gas range <br />! Clothes dryer <br />�—j Range hood <br />Exhaust fan <br />Heat pump <br />� Unit heater <br />� Boiler <br />Woodstove <br />Ductina <br />SPRINKLER / SUPPRESSION S <br />Number of Heads <br />Other <br />of Use <br />�'L.1.a-b'ti i3 i hi� �1�<� ���le � <br />��%l1i 3�.- �'W.1�1� - o0S <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />Bathtub <br />Shower <br />Kitchen sink & dis <br />Dishwasher <br />Clothes washer <br />Water heater <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 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 ihe owner of this property to perform the wo�k fo� which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />— �___�� <br />_�--� <br />Owner/Authorized Agent Signature Date <br />(Revised 3/2013) <br />