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P�RMI�" AP�LICA�"ION <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: <br />1 ���.�- I I��� <br />LEGAL for new construction: Short PlaUsubdivisi <br />NER <br />5� ��� �- <br />ERTY TAX # <br />PEhZA/IIT # <br />No. (attach copy of long legal description) <br />PhonelE-mail <br />� <br />Atltlf0S5 Il�llY/JltllC/LIFI <br />APPLICANT: _ Owner _ Owner's Agent v COfllfeCfOf _ COf1ff8CY0f�5 ACJBfIt _ TBfl2fll (musl provide a letter of consent from Ihe owner to do work in ihe space) <br />CONTRACTOR Lr�� '�(lil4��j� State Lic. # L L}��, � �� �5�(7� City Bus. Lic. #�,5,jL56 <br />Address L�'� 1�L� I�LL PhonelEmail <br />, <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />� � '���'� (- Phone/E-mail ' <br />BUILDING PERMIT APPLICATIOIV CONTRACT PRICE OF WORK <br />Existing Use of Building i i�-(� HEAT SOURCE: <br />Proposed Use of Building �} �� CC� Gas_ Electric_ Other_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of projecl: ._ New _ Addition _ Remodel _ Repair _ T.I. =Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPI ION OF WORK (additional space provided on the back): <br />� <br />�� , �� �- ��� 1/z ����� - � �� � �c� �� s; �z �� �- <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 />Exhaust fan <br />Heat pump <br />� Unit heater <br />� Boiler <br />� Refrigeration <br />I Woodstove <br />� Other <br />SPRINKLER ! SUPPR�SS18F1 Sl(�'�EiVi <br />� Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New Y Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />j � Toilet <br />� Bathtub <br />C � Lavatory (wash basin) <br />� Shower <br />}� � Kitchen sink & disposal <br />� Dishwasher <br />i Clothes washer <br />� � Water heater <br />� Sink (service/bar/mop/etc.) <br />� Backflow preventer <br />� Urinal <br />j Drinking Fountain <br />� Floor drain <br />� Grease trap <br />� Roof drains <br />I Medical Gas <br />IOther: <br />I otne�: <br />I nereby 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 complied <br />wilh whether specified herein or not. The granting of a permit does not presume lo give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I am authorized by the owner of Ihis property to perform the work for which application is made and I comply with the Slate Coniractors Law 18.27 RCW and 296.200A WAC. <br />�a �z2�� <br />Owner/Authorized A ignature D te <br />(Revised 3/2013) <br />