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� • <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 />SITE ADDRESS: ` PROPERTY TAX # PE IT #!� / <br />� i.J �� 5 i, (' �,l �' 2�" + �ti�Lc: c ���`l 1/' �� v V � V" <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER <br />Phone/E-mail ��,�,� <br />City/State/Zip �, ` ' <br />_..�rj-rr_-n7i �>t . <br />Cf ""1 <br />APPLICANT: _ Owner _ Owner's Agent �i Contractor _ Contractor�S Ag2flt _ TEflefli (must provide a lette� of conseM from the owner to do work in the space) <br />CONTRACTOR �,r �•� � �,,,. (. �„�. State Lic. # V � � C, ' rs City Bus. Lic. # �'.� '�;,1 , <br />�Lc�, y-�3 - 3���� <br />Address ��% 1,�- ��2�"' � j 1,-,J ��u'3� Phone/Email yy�;,.� cr✓� � �i �� �^-� <br />✓ o� r <br />TENANT BUSINESS NAME CONTACT FOR PERMIT -3� �,� j�ttl; YK���' <br />I'� `� � 5 Phone/E-mail �j t,1 ry <br />�Z J.- �.I�lL.I . . �� � ,. '.A YL �(i <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK S�-1 S.%� <br />� <br />Existing Use of Building �f �'JV S � CS h2��..� f <br />Proposed Use of Building (�v hy �S 1`^C-►�"�it�u.r'�' <br />Building type: _ Single Family � Duplex _Townhouse _ Multi-Family <br />Type of project: New Addition X Remodel n Repair _ T.I. <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />CXc�cs � � ' <br />i,� �- � t� z' : _ `� "l'ii � <br />c'��:�..���,� ��,}��:.� ,,s t�> Rt�/� <br />►v`���," �r�y��•r� ✓c���r4s,f�� E-; �tf��r-c> <br />Commercial <br />Sprinkler <br />HEAT SOURCE: <br />Electric Other <br />ion Change of Use <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair Type of Project: _New _Addn �Alteration X Repair <br />Show Number (#) of fixtures Show Number (#) of fixtures <br />I A/C — air handling units '[. Toilet <br />� Forced air systems Bathtub <br />Gas pipina Z � Lavatory (wash basin) <br />vvater neater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />ttetngeration <br />� Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />, Number of Heads <br />! Shower <br />� Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />i Water heater <br />Sink (service/bar/mop/etc.) <br />I Backflow preventer <br />� I Urinal <br />j Drinking Fountain <br />� Floor drain <br />I Grease trap <br />i Roof drains <br />� Medical Gas <br />L i Other: ��,�,� > i�v� <br />i 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 aulhorized by the owner of this property to perform the work for which application is made and I comply with the State Conlractors Law 18.27 RCW and 296.200A WAC. <br />�� %' <br />�' �t� ���"' / C. %� ly.%.'. l , ,i <br />�wner/Authorize gent Signa ure D te <br />(Revised 3/2013) <br />