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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 />SITE ADDRESS: PROPERTY TAX # PERMIT # <br />. Ir JC�b 3"������t70�{ �,? t3i5o8 -olo <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER � (^, � Phone/E-mail � 70(,� � � � - ! �5 ? � � � � � � � � . <br />Address � � � � City/State/Zip �� i ^,> a � ��'� �` J �` � � � i <br />/ <br />APPLICANT: � Owner _ OwnePs Agent _ Contractor _ Contractor's Agent _ Tenant cm�s� a����ae a ieue� o� co�sen� rrom me o�,e� m ao ,,w�k �n �ne sPac�� <br />CONTRACTOR � e. `" State Lic. # City Bus. Lic. # <br />Address Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building J "' ` "` � --�" ' � ' `= HEAT SOURCE: <br />Proposed Use of Building �� Gas Electric %� Other <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />T pe of pro ect: New Addition Remodel Repair _ T.I. Si n Sprinkler Demolition Chan e of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : ( , � <br />� r \ <br />�,�y � � y i �' ��. . -' �c,., �'- , �a�ti�. �v��.% I �� a- ' ; �:, t <br />1,( � � <br />h L c YC `� C i ���� .� � � � i . i � � �� , �' !.. .. �A. � � -% � E �,� ��f , .' �"�„_� � � � . r�_ , � . �, �. n: � i p �. ,�, � . .. <br />rt <br />-�4� � ti .�� � _�,��,r. � '-� ���f � �, � � � , I L �, , 4� 1, 2 � � � �� � � > a �, ., ; ��� � 9� � r� �� � s _ <br />MECHANICAL PERMIT APPLICATION ' PLUMBING PERMIT APPLICATION <br />Typ of Project: _New _Addn _Alteration _Repair � Type of Project: _New Addn _Alteration _Repair <br />Show Number (#) of fixtures Show Number (#) of fixtures <br />A/C — air handlin units Toilet <br />Forced air s stems Bathtub <br />Gas i in Lavato wash basin <br />Water heater Shower <br />Gas fire lace Kitchen sink & dis osal <br />Gas ran e Dishwasher <br />Clothes d er Clothes washer <br />an e hood Waterheater <br />Ex ust fa Sink (seivice/bar/mop/etc.) <br />Heat p Backflow preventer (inside bld ) <br />Uni ea Urinal <br />iler Drinkin Fountain�� <br />� Refri eration Floor drain <br />Woodstove Grease trap <br />Ductin Roof drains <br />Other Medical Gas <br />RINKLER / SUPPRESSION S TEM Other: <br />INumber of Heads 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 governing this type of work will be compl <br />with whether specifed herein or not. The granting of a permit does not presume to give authonty to violate or cancel the provision of any other state or local law regulating constructioii <br />That I am au onzed by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. <br />� f <br />� !j' F,il c' . � � '� � 2 � i� <br />u <br />Owner/Authorized Agent Signature �— Date (Revised 4/2015) <br />