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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: /- �,' PR a�5'CC{Glf; iC'CG� P�� I� C'"! – CD C� � <br />r.���7 D� 5! S� Si�r"fe y� 1 <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />--� ' , . . - - . ._ __ . <br />OWNER .� � 3 � r�(�.^•")�G9 S�'IC i�'t",C Phone/E-mail ---'"�` —� <br />Address ,� a�' jjC�� � rjl' ��C�(,�� ��- . Cv J� City/State/Zip <br />APPLICANT: _ Owner _ Owner's Agent � Contractor _ Contractor'S A90f72 _ T2f18f11 (must provide a letler of consent from lhe ovmer to do work in the space) <br />CONTRACTOR ��` I��e-�i �!✓� ��'t � L& I Lic. # COE Bws. Lic. # <br />Address // �� �t� S T 5� ,'l?C.�%L�� �-✓7C� Phone/Email �i �-�.�1��%�/Q/'� �y�r/{j�-�'l�7Cr <br />TENANT BUSI ESS NAME CONTACT FOR PERMIT <br />`, U�( U �,v � �`C ��� � �ys/ Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK C._'z'_QJ <br />Existing Use of Building `f G� C�n f HEAT SOURCE: <br />Proposed Use of Building Gas Electric_ Other_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family /� Commercial <br />Type of project: _ New Addition Remodel Repair _ T.I. _ Sign _Sprinkler �Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : //�� yL /� j�� <br />t � � ..117, � %`-1 �r l ��7� ' l�� l�� �r7'� S i. ✓ !• S ��/— <br />G �, t��� � ��, y--r��_j p�N��. ':� �- c� i / <br />�' /�l c� �� � 1„J �� 't C%� f r���� ��'r— j o� ?"c"� C-� l}%�� <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair Type of Project: _New _Addn �Alteration _Repair <br />Show Number (#) of �xtures Show Number (#) of fixtures <br />A/C – air handlinq units I Toilet <br />Gas fireplac <br />Gas range <br />Clothes dry� <br />Range hooc <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Shower <br />Kitchen sink & d <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/ba <br />Backflow prever <br />Urinal <br />Woodstove � Grease trap <br />Ducting Roof drains <br />Other Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM Other: <br />Number of Heads Other: <br />I hereby certify that I have read and examined this application and know the same to be We and cortect. All provisions of laws and ordinances governing this type of work wiil 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 property to perfortn the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />,�/ ��``��� � �! / y <br />q�Dt r/Authorized Agent ignatyce� . Date (Revised 6/2012) <br />