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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 />SITE ADDRESS: -, IPROPERTY TAX # <br />s �(�� C��j��� i��� <br /># <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER �1 � G,� Jl` %�v.� c� � <br />�� ( o( �!C^�G's 0�7 �u- eYl J.'7 � Phone/E-mail � �>C �/ �% -- 3�/ 1 ,� c- �/� <br />Address �-f3S- ��-�;k� s a�-,�nu,�/S �, G'Ew' City/State/ZipSCL�!�?�'IGi.o'1J; � �U � �U �Li' <br />APPLICANT: _ Owner /� Owner's Agent _ Contractor _ Contractor�S Ag@Ilt _ TEfl811t (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR � c�,.T- -ir,�� �j�. � ��P M�i c�iY % State Lic. # K C�/� �C(r�� � 5�l�`' City Bus. Lic. # ^��"+ t� <br />Address �� � � � Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />ExistingUseofBui�ding S� �t." Z' 1.��,�fG.��� HEATSOURCE: <br />Proposed Use of Building -S ti�.5 �� ��'t-"'� 1. �� Gas_ Electric <br />Building type: �ngle Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition :�Remodel �Repair .� T.I. Sign M�S rip �n{<ler _,_ Demolition_ Char <br />11 <br />Use <br />DESCRIPTION OF WQRK (additional space provided on the bad<) : / r-�r� � <br />� �OtJ�!� L.1'1 ��v �J�c���:j,,'t i <br />c �.�- � �� � f--%.-�� �ril �� � �� rnd� �---� i �Y�, h /'n� Cz�� � � c G��l��� ► . <br />�; � i� -i-��,-�, � �.� m ove 2���-c ��S � o n Q. i r� ��vl-�.�y -�'� �� c� � �� <br />�ol,� e �" -l`I <br />MECHANI�AL PERMIT APPLICATION <br />of Project: ._New_Addn �Alteration v�2epair <br />Show Number (#) of fixtures <br />� A/C — air handlin units <br />Forced air s stems <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ran e <br />�� Clothes dryer <br />� Ran e hood <br />� Exhaustfan <br />� Heat um <br />Unit heater <br />I Boiler <br />Woodstove <br />Ductinq <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn �Iteration �Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavato wash basin <br />� Shower <br />� � Kitchen sink & dis osal <br />� Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <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 coinpl <br />wilh whether specifed herein or nol. The granting of a permil does not presume to give aulhonly lo violate or cancel the provision of any other state or local law regulating constnaction <br />That I am authoriz by the owner of t property lo perform lhe work forwhich application is made and I comply with the State Conlractors Law 18.27 RCW and 296200A WAC. <br />� ' _ 2 - �i — l � t��Z <br />Own horized Age � nature Date " (Revised 9/2014) <br />