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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 />E AD E S: �}fj �� PROPERTY TAX # PERMIT # <br />D '� 1rJ �AS�NO `P.D ���Q,F.TT �6 �� .5 f! - O 37 <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER �b���G Phone/E-mail <br />Address �� �� 3�i�� ��S U�'�'��� City/StatelZip �,[A1 1 IL,�,, ,/�%A -Ib��.�f'—Z,Z,(�% <br />APPLICANT: � Owner _ Owner's Agent _ Contractor _ Contractor's Agent _ Tenant �must Provide a ie�cer otconsen� from u,e owner �o do work in tne space� <br />CONTRACTOR "T�j��' (�,�$°j �y;tj-n�N State Lic. #"; U,�;��.�?�"� p'? City Bus. Lic. #(}�D�b <br />Address Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />�� DC�A`t �IL 9 a5-�� �0 �� � <br />Phone/E-mail }�� � � <br />BUILDING PERMIT APPLICATION cONTRACT PRICE OF WORK ` 7S'. i��✓O <br />Existing Use of Building ��� HEAT SOURCE: <br />Proposed Use of Building M F� Gas Electric other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: _ New _ Addition � Remodel _ Repair _ T.I. Sign Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />���^v c, � (� ) (".�1� �l�� �� ���r y �,� �i �rt� F�'-f�' �� �} Tur,�rs ��e� � �-� s��..�� <br />F`��'�'^ iU � � �-�i 6c.�� s'E ,� � iNs /�� �1i,� .2C�a <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures Show Number (#) of fixtures <br />A/C — air handling units_ Toilet <br />Forced air systems � Bathtub <br />� Gas piping Lavatory (wash basin) <br />� Water heater � Shower <br />� Gas fireplace � Kitchen sink & disposal <br />� Gas range Dishwasher <br />� Clothes dryer � Clothes washer <br />� Range hood � Water heater <br />Exhaust fan Sink (servicelbar/mop/etc.) <br />Heat pump � Backflow preventer <br />Unit heater � Urinal <br />Boiler I Dfillklllg FOUntain <br />SPRIN <br />Woodstove <br />Ductina <br />R / SUPPRESSION SYSTEM <br />Number of Heads <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 the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. <br />� <br />5��--.:.,l�l � �.. i / �-�¢,� ,' <br />Owner/A orize gent Sign ure '�e <br />(Revised 3/2013) <br />