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� • <br />PERMIT APPLICi4TION <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 ADDRESS3 3 3 0 /Lj� I/ PROPERTY TAX # PE�MIT # r <br />� Y i � � L � ,� ��'� ��� �,� <br />LEGAL for new construction: Short PlaUsubdivisio� � ��% �I �,,,�(a f loi� i L,C v ! x <br />OWNER N/�iC L L` Phone/E-mail Z'�--Z�� �� 3� 6 <br />Address ZC! ��' Z .Ewi �^- � City/State/Zip G�/E-�-E rT �i'✓L= 5��� <br />APPLICANT: wner _ Owner's Agent _ Contractor _ Contractor�5 AgOfll _ T2�8fl1 (must provide a letler of consenl from the owner to do work in the space) <br />CONTRACTOR Qw�/G��— <br />Address �'�j // �L �w� �T " / <br />TENANT BUSINESS NAME <br />�/✓/ T�� �� „� � 4 — �--7`'/�c/ <br />BUILDING PERMIT APPLICATION <br />State Lic. # City Bus. Lic. # <br />Phone/Email G/��"Z��'� / ��p�o <br />CONTACT FOR PERMIT � <br />Phone/E-mail � " ��E � - <br />CONTRACT PRICE OF WORK <br />Existing Use of Building �i�/� �f�. ��S�G � <br />Proposed Use of Building li✓� ��-- �� `'� S� <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family �Commercial <br />Type of project: New Addition Remodel Repair �T.I. Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the bacl<) : <br />,t-� c%� /v�.,.� �....•a /�S -�-- .S Lo �..,to-a�►�. <br />_�� �41J � .�-Q ----, /o � S-�.o. , ,�..�.,•� <br />Gas <br />� � <br />HEAT SOURCE: <br />� Electric Other <br />Demolition Change of Use <br />..c� `%�/ ��- <br />cJ ,✓ � ��iG. /20G1/ <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />i A!C — air handling units <br />� Forced air systems <br />Gas piping <br />� Water heater <br />Gas fireplace <br />i Gas range <br />! Clothes dryer <br />i Range hood <br />( Exhaust fan <br />Heat pump <br />; Unit heater <br />Boiler <br />i Refrigeration <br />� Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />f Number of Heads <br />pe 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/e <br />Backflow breventer <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 goveming 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 lo violate or cancel the provision of any other state or local law regulating construction <br />That I am autho ' ed e 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 />�I� <br />� /� � — � G/ <br />O horized Agent Signature Date (Revised 3/2013) <br />