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• <br />�ERMIT 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 />PROPERTY TAX # <br />1 �n(; <br />LEGAL for new construction: Short PlaUsubdivision � Lot No. (attach copy of long legal description) <br />OWNER �C�X�� <br />Address l � �l� � �I 1 <br />APPLICANT: _ Owner <br />CONTRACTOR C _� Y <br />Owner's Agent � Contractor <br />Phone/E-mail W 4lri — 4+�,► ; I-' <br />City/State/Zip <br />Contractor'S i�g@flt _ T21l8f11 (must provide a letter of consent from the owner to do work in Ihe space) <br />State Lic. #� <br />Bus. Lic. # <br />Address �G." � � \ � � �`v`� Phone/Email 4 � - L%t'l�- - �� Z2 <br />TENANT BUSINESS NAME CON ACT FOR PERMIT �• � <br />' � 1�1�,�(,� (:�. <br />� , IM � Si _7 ' �' �'',n�.�ilc,�� �u'n�C�.�' � 5 <br />r . "--� Phone/E-mail -x"j �i1'v.� l.`"�� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK , 1 L;�1 .�b <br />Existing Use of Building l�� �� <br />Proposed Use of Building j�;,�_� <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: New Addition Remodel Repair 'f T.I. Si n Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />HEAT SOURCE: <br />Electric _ Other_ <br />emolition Chanqe of Use <br />I��� �ur � ��\1�. ,���i �-�.,�,�,.�„r�-�- �-�� c�— �j� };�p � �, � - <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />� Gas fireplace <br />( Gas range <br />Clothes d er <br />Range hood <br />{ Exhaust fan <br />; Heat pump <br />i <br />Unit heater <br />Boiler <br />` Woodstove <br />Ducting <br />; Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />j Toilet <br />I Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer (inside bl <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 ro be true and correct. All provisions of laws and ordinances governing this type of work will be comp <br />with whether specifed 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 18.27 RCW and 296.200A WAC. <br />11 ? �_ 1- r ��%/ <br />OwnerlAuthorize Agent Signature Date (Revised 4/2015) v <br />