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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: � • oonocorv rnv tt PFRMIT tf <br />��Z� IIZ� <br />LEGAL for new construction: Short PlaUsubdivisi <br />OWNER C/�i 1�[�� ,(�Y'�ilf <br />No. <br />Phone/E-mail <br />� Gc.� <br />(attach copy of long legal description) <br />._z��-2z`�� <br />��v f�G� `il�.-� ICity/State/Zip 4—L�1''�V L� �� Lti.:i—J � n��C�'�/ <br />CANT: _ Owner �Owner�S A jBflt _ COf1Lf8CtOf _ COf1tf2CYOf S Ag@Ilt _ T2f1811I (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR �T L & I Lic. # <br />4ddress Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />`����CG�-�) I '\ �l:i i � � �� � � � � ��5��.- � f <br />Phone/E-mail t.'Z< -- '. � ' <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �j <br />Existing Use of Building '�� G1. . CU 'l%CX� <br />Proposed Use of Building� V�'.�rr� ���' m►�= <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-F.amily Commercial <br />Type of project: New Addition % Remodel Repair lq�_ Sign _Sprinkler _ <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />� ����i� d 1� -� � �� n�.� <br />�v� �,���, nc,� �,(,�,�m,S, v� � � � , <br />,. C� �%n � t �r n , o . _ � � _. � , a ,� . r1 ., . <br />�"". `(,'� t l�V �\ J. J ��� ��� <br />MECHANICAL PERMIT APPLICATION <br />Type 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 I SUPPRESSION SYSTEM <br />Number of Heads <br />COE Bus. Lic. # <br />.� <br />HEAT SOURCE: <br />Electric XI Other <br />Demolition_Change of Use <br />C�r► �►�� , r�c,�, -�-, �� <br />� - -f-� � Dl,..��, . <br />- � , J� � r-� <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Num6er (#) of fixtures <br />h <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/b� <br />Backflow prevei <br />Urinal <br />Drinking Founta <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 rype 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 conslruction <br />That I am authorized by the owner of this propeRy to perform the work for which application is made and I comply with lhe State Confraclors Law 18.27 RCW and 296200A WAC. <br />_. f � ) <br />� ,�, v� �Z ,., . � <br />OwnerlAutho zed Agen Signa D te (Revised 6/2012) <br />`J� <br />� <br />c c_; �� <br />