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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 />ITE ADDRESS: PROPERTY TAX ti P� �VIII f r� � I( �-\ <br />i D o 7 S E Fvn�'R �1,��I u�4 �� /VI �--r -� v <br />GAL for new construction: Short Plat/subdivision " Lot No. (attach copy of long legal description) <br />dress <br />Phone/E-mail <br />ate/Zip <br />APPLICANT: _ Owner _ Owner's Agent � Contractor _ Contractor�S Ageflt _ T2112f1f (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR x , � /V� �CiIQM +��I •Z/UG State Lic. # D �G '#OO��City Bus. Lic. # � � � �'G <br />� , � <br />Address 3 3 5,3 !� s r 4 s�. */�� ���� "V'4 Phone/Email � �(; � <br />TENANT BUSINESS NAME CONTACT FOR PERMIT ��MGS T)G �! IrN <br />� U /� Phone/E-mail S3��y„S FjZO� KV�t6f�<ANI.�f� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ��.�00.�• <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas_ Electric_ other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family .� Commercial <br />Type of project: New Addition Remodel Repair X T.I. _ Sign _Sprinkler_Demolition_Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />Il<AdLJ[ AqlD Tft'�7/�lCG /O Sc� PP� �Y�lf�'S7�/rs �' —�7C'+�.t �rf� 5�++►"S <br />�'� s�� r;.,5 �t �c �. � f'�oo,�r � p v�.� r p,• p� ��v�.,� z.r�.,�s�' �".... s <br />:.� �! dsM S w� 0 i Nr.,J S/ii �� 7,►rS <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 />i A/C — air handling units Toilet <br />� Forced air systems Bathtub <br />� Gas piping � Lavatory (wash basin) <br />'; Water heater ! Shower <br />i Gas fireplace Kitchen sink & disposal <br />I Gas range Dishwasher <br />! Clothes dryer � Clothes washer <br />} Range hood j Water heater <br />a t Exhaust fan Sink (service/bar/mop/etc.) <br />Heat pump � Backflow preventer <br />� Unit heater I Urinal <br />i Boiler j Drinking Fountain <br />j Woodstove <br />I Ducting <br />� Other <br />SPRINKLER SUPPRESSION SYSTEM <br />. � umber of Heads <br />� Floor drain <br />I Grease trap <br />I Roof drains <br />� Medical Gas <br />i Other: <br />! Other: <br />I hereby certify t I ha read a d examined this applicati�nd 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 s ifie re r ot. The granting of a permit d es 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 rize ow r of this property to perfor he work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />thoriz�d/Agent Signature <br />!"��/ <br />Date <br />(Revised 3/2013) <br />