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• <br />� <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGi�/SPRINKLER/DEMOLITION <br />CITY OF EVERE�TT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: PROPERTY TAX # P RMIT # <br />���1 �v�y�ruv� lA.'�-� oc 3 �2gve$^dr�loo ����J��' Qi) <br />LEGAL for new construction: Short Plat/subdivision <br />Lot No. (attach copy of long legal description) <br />OWNER (� at r-et+1 �-D Phone/E-mail <br />Address (O(v l� �1 ��s �( R� /�t5� -tL�u City/State/Zip pp�r �� �� j � � �� � � <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor'S Agent _ Tenaflt (must provide a letter otconsent frcm the owner to do work in ihe space) <br />CONTRACTOR i� S..� rc5'r L& I Lic. # COE Bus. Lic. # <br />Address 20 � �ra �t� �„f' /� Sjt C �`� h h � � U%i� 7i�d `r 1 Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT �� ��s <br />l�l ael .t.z�s Sfi�ar�% � $',i�1� Phone/E-mai1253-S33—IZ-4 �Rs o1 ��fts <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building � vc�,wh lL n�� wrv�,f" HEAT SOURCE: <br />Proposed Use of Building S/�� � Gas_ Electric Other <br />Building type: _ Single Family _ Duplex _Townh use _ Mult�i-Family _ Com�mercial <br />Type of project New Addition Remodel Repair l�(T.I�� Sign V�prinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�r �s p��J t c,�- f � �- �{ n a h� l- .� P� �j�'i� 5���' e t-. i.w ..I- c`� ,Ad ��� /o r�. c-lo � w i► �} <br />s�r�nKitvs � Gt.Ct�Yri^"�'o�ri� /UC+-✓ G9�Sti ��lw� �rar�w� q�" %ha �pnhvn�+-6`� �Irl�: , <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />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 dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />' Ducting <br />' Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />�j Number of Heads <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />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 <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 thal I have read and examined this application and know the same to be lrue and correcL All provisions of laws and ordinances governiny this lype of work will be complied <br />with whether specified herein c�noL The granting of a permit does nol presume to give �ulhorily lo violate or cancel lhe provision of any other slate or local law reg�tlating construction <br />That I am authorized by the oyner of this property to perform the work for which applicallon is made and I comply wilh lhe Slale Conlractors Law 1827 RCW and 296200A WAC. <br />OwnerlAuthorize�Agent Signature <br />(Revised 6/2012) <br />we.s t:�., <br />