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�ERMIT APPLICATIO� <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ADDRESS: � �h � PROPERTY TAX # P RMIT # <br />1���-, 7 �� SC Z�os i�����=�-i�� I�iG � C`i0 <br />for new construction: Short PlaUsubdivision <br />No. (attach copy of long legal description) <br />OWNER �('4z �"1c� �'L�ca�3 {� L�tif� � - �v�re � Phone/E-mail <br />4ddress � j � C� I{� ��� �� City/State/Zip L���L� � �✓��� `i Q i� 3 <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor ✓ Contractor'S A9211t _ TBI1811t (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR ���rc ,^P2� I ��-"F✓� � e r�.�i ��:-� L& I Lic. # C� F:12 L� �K S`I i� L COE Bus. Lic. # E�"I �'I 3 SU <br />4ddress � �� `� �✓C� �� ' � �'r . '�- i�"tc wi� � � ���3 Phone/Email %D C -� C� j " (� � '-� <br />TENANT BUSINESS NAME CONTACT FOR PERMIT/1 ,�������� <br />_C�Y <br />�jWS'�`�G,� Lti�nn�l��n; F� ��/tu��L� Phone/E-maii Zil6-?C, j- lZ�l4 zy+.2si� wle,i��'z��.-��-,l�v,c-c�,-, <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � Z`� ,�`� �_� <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family ✓ Commercial <br />Type of project: New Addition '� Remodel Repair _ T.I. _ Sign _Sprinkler _Demoliti <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />� � � � �_ � ,., l ��' <br />� vi 5 �i'� (.�Lu,>� :�b��i L� ?�-'-'.. � L `i � C�*- +,�^� �� ��'Zwi,� � c '� i.�wlC G,✓�. 1 ` � 3 � cl,I. ✓kv� . <br />� <br />MECHANICAL 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 />�{ Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />; Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Electric Other <br />Chanqe of Use <br />PLUMBING PERMIT APPLICATION <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 & dispos <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/moF <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 that I have read and examined ihis 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 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 construclion <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 />��,%��� ID J `�( �� <br />Owner/Authorized Agent Signature Date <br />(Revised 6/2012J <br />