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�ERMIT APPLICATION <br />BUILDING/MECHANI�CAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />GITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, V�/A 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />SITE ADDRESS: <br />1� 7 i l.� �� C�� L v <br />PE T�ILTAX q PE MIT # <br />i��' -ylq� �►�iG�C� tl I 31I <br />� <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER <br />Address <br />APPLICANT: _ Owner _ Owner's Agent <br />CONTRACTOR % / rS T � 'E'�'�,s <br />Address � b ��� �%�� �-y +� �{ <br />TENANT BUSINESS NAME • <br />i�i��a,�-ls r �60�,1.�1.r <br />Phone/E-mail <br />City/State/Zip <br />C011ifaC�O� _ COIllfBCtOf�S Ag@fll _ TBflaflt (must provide a letter of consent from the owner to do work in the space) <br />r State Lic. #�//";S � ' City Bus. Lic. # <br />� '�( �� �� Phone/Email �j� j ; <br />CONTACT FOR PERMIT-� �/ nn`� � I,, <br />� _ l�i% /inw Silt. !/ l(Ml� �� s %��� <br />BUILDING PERMIT APPLICATIiDN <br />Phone/E-mail ��� •}G <br />CONTRACT PRICE OF WORK <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex __Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�`Z f�� ea���, �-1 �G�Li <br />MECHANICAL PERMIT APIPLICATION <br />pe 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 />I Gas ranae <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refriperation <br />� Ducting <br />I Other_ <br />SPRINKLER / SUP <br />Number of Heads <br />ION SYSTEM <br />HEAT SOURCE: <br />lition Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />Bathtub <br />I Lavatorv (wash basinl <br />Kitchen sink & disp <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <br />Urinal <br />Drinking Fountain <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 Iaws 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 construction <br />That I am authorized by the owner oi this properly to perForm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />� ��. �5.�0�3 <br />�jL <br />ner! uthorize Agent gnature Date (Revised 3/2013) <br />