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;�,�� <br />�'ERMIT A�'PLICATIOtv <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEM�LITION <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: �/� ,-) �/1 ,_.... PROPERTY TAX # <br />I. ��, I� ��� �f 1n 5 I��=. 57� /� ��6�� ��yn� <br />LEGAL for new construction: Short PlaUsubdivisi <br />OWNER �—IT 1� aj �,�� I�C I"� �� cJIM�! PI„� <br />Address /�' �.J, %��x � �,� � <br />APPLICANT: _ Owner _ Owner's Agent ,�..Contractor <br />CONTRACTOR G�� i� I'� ���v Cp,nS�Jt�v�i; <br />Address sSc�,� I��� t L�/ �,� � LV ,/_�.-_ hh <br />TENANT BUSINESS NAME � <br />�I ������� <br />BUILDING PERMIT APPLICATION <br />Lot No. (attach copy of long legal description) <br />( ��'�� l'� ��— <br />Phone/E-mail �.-< � y <br />City/State/Zip � ( I � �,it �% � �/ ,�� �/ <br />COf1lf8CtOf S AJeflt _ TBf1811t (musl provide a lelter of consent from the owner lo do work in the space) <br />State Lic. # 'l � � 1.� S� �dC,, � —' ' City Bus. Lic. # ` ��� � , ' <br />\�� <br />,� � J •�. Phone/Email �`'c� �- �� � ` ,�'',� � � <br />CONTACT FOR P RMIT <br />%� p ��- ��''�:'�'`''� �"`, <br />Phone/E-mail �/ -•7'y � �i'� /' <br />CONTRACT PRICE OF WORK �� • C�� <br />Existing Use of Building ! �!" � <br />Proposed Use of Building�� � � i•f� +� ���� � <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _�Commercial <br />Type of project: New Addition _ Remodel _ Repair �-T.I. _ Sign _Sprinkler <br />D SCRIPTION OF ORK (additional space prov�ed on the back) : <br />���1 � v� ��� ��N �a r.,.k�. av. �x�,����- <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: �dew _Addn _Alteration _Repair <br />Show Num6er (#) 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 range <br />� Clothes dryer <br />� Range hood <br />j � Exhaust fan <br />� Heat pump <br />� Unit heater <br />� Boiler <br />� Refrigeration <br />I Woodstove <br />�, � Ducting <br />� Other <br />SPRINKLER / SUPPRESSION Sl(STEIVI <br />� Number of Heads <br />HEAT SOURC : <br />Gas_ Electric`� Other_ <br />Demolition Chanqe of Use <br />PLUM�ING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Num6er (#) of fixtures <br />� Toilet <br />� Bathtub <br />� Lavatory (wash basin) <br />� Shower <br />� Kitchen sink & disposal <br />I Dishwasher <br />� Clothes washer <br />i <br />� Water heater <br />� Sink (service/bar/mop/etc.) <br />� Backflow preventer <br />� Urinal <br />i Drinking Fountain <br />� Floor drain <br />� Grease trap <br />� Roof drains <br />I Medical Gas <br />I Other: <br />� otner: <br />I nereby certify lhat I have read and examined this applicalion 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 whelher specifled herein or not. The granfing of a permit does not presume to 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 this property to per(orm the work for which application is made and I comply with the State Conlractors Law 18.27 RCW and 296.200A WAC. <br />-- �,— �'_. _ . i <br />_� —' ' � ly <br />u orized Agent Signature , Date (Revised 3/2013) <br />