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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 />E ADDRESS: P p ��` l/� t�i ��. S-� - �PROPERTY TAX a <br />, l�':,�u � [� L v e.- z�f� r.✓� l��..; c <br />IT # <br />L for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />ER <br />Phone/E-mail <br />Aadress ��.nyi�iaiei�ip <br />APPLICANT: _ Owner _ Owner's Agent ✓Contractor _ Contractor�5 A9ellf _ T@�2lli (musl provide a letterof consent from lhe owner to do work in the space) <br />CONTRACTOR � u ca ��`-� �-+ ��,� State Lic. # City Bus. Lic. # <br />? C: Z:. .: P/..�:-, 6:�:y � <br />Address / C' � 6 y f<, f � 5 L, �c j%'C �� �'✓/1 ��i � / � Phone/Email `f..2 y - � .G� �;�0 / r ,~• cL: /, cc. <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />t / <br />Phone/E-mail %t� •^-� r G< i C v v.' L <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse iLMulti-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler _ <br />DESCRIPTION OF WORK (additional space provided on the back) :� e p�� ���,-7 �,� � <br />� ; �� � .� rj r o ,- � � r� : � s �.,� t� - � cC'rr l g �t n : 'f <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 />j Gas piping <br />Water heater <br />Gas fireplace <br />I Gas ranae <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 />Number of Heads <br />HEAT SOURCE: <br />Gas Electric � <br />�molition_Change of Use <br />o�' « I r �,.� �, f��.. <br />c��tc��� b�,, . I��l. ,� J. <br />PLUMBING PERMIT APPLICATION <br />ofProject: _New_Addn �Iteration ✓Repair <br />Show Number (#) of fixtures <br />� Toilet <br />; Bathtub <br />j Lavatory (wash basin) <br />� Shower <br />i Kitchen sink & disposal <br />j Dishwasher <br />j Clothes washer <br />Water heater <br />i Sink (service/bar/mop/etc.) <br />� Backflow preventer <br />j Urinal <br />� Drinking Fountain <br />j Floor drain <br />Grease trap <br />; Roof drains <br />; Medical Gas <br />i Other: <br />� Other: <br />I hereby certify that I have read and examined this application and know the same lo be true and correct. All provisions of laws and ordinances governing 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 to violate or cancel the provision of any other state or local law regulating consiruction <br />That I am authorized by the owner of this property to perlorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />«-� �-�b- �3 <br />Owner/Authorized Agent Signature Date (Revised 3/2013) <br />