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• <br />• <br />PERnIIIT APPLICAI'IOIV <br />BUILDIMG/i!lI�CHANICAL/PLUMBING/SiGfV/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: / t ' IPROPERTY TAX # I PERMIT # �` p <br />�g� � C/i-t� j 17U�"IV �� �� V L't% I <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER <br />ress <br />Phone/E-mail G �a.Yk.� <br />City/State/Zip <br />� <br />APPLICANT: _ Owner � Owner's Agent _ Contractor _ Contractor�S A j2f1I _ T2i18f1t (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR ( /�' v � ' ��. � 7^r: �?'' t�''�;) <br />U l`�� � �� �'�G� -%� � Z-G�� State Lic. # � f,��(� 1G9 G N'�(�� � k.� (City Bus. Lic. #� �-,�� �� <br />Address Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERNiIT �25� 2S7 g�7 <br />Ct�z.�s ,L.AI��-l�- <br />�����% �'�-- l� Phone/E-mail Gk�.V"�-� �1J(�V'G w� • �/ <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK r`Hl,(,�L{i� <br />Existing Use of Building ��G� � i�L�-i�Gi.� �p�11i2-� HEAT SOURCE: <br />Proposed Use of Building ��1j�2.E�(�$� ����^��G[� ��Q��Z Gas� Electric <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family %� Commercial <br />Type of project: New Addition � Remodel Repair _ T.I. _ Sign _Sprinkler _Demolition�ChangE <br />I�ESCRIPTION OF WORK (additiona! space p�ovided on the back) : <br />-t��s� �o��r W�ty GoNv�(�T �+� U�P�tz �C-� ct= .zSt► o��� <br />��OPJ� o��iG� ��Ci� � WAI2��..,(�. S�PiC'.� (��<(iv� IeVP_I � <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 />I Gas range <br />� Clothes dryer <br />-� Range hood <br />( Exhaust fan <br />Heat pump <br />� Unit heater <br />! Boiler <br />i Refriaeration <br />0 <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Other <br />of Use <br />�V�' . <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn X Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />j Lavatory (wash basin) <br />Shower <br />� Kitchen sink & disposal <br />i Dishwasher <br />Clothes washer <br />i Water heater <br />I Sink (service/bar/mop/etc.) <br />I, Backflow preventer <br />I. Urinal <br />� Drinking Fountain <br />! Floor drain <br />I. Grease trap <br />� Roof drains <br />� Medical Gas <br />I <br />j 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 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 slate or local law regulating construction <br />That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. 1/ <br />I� <br />G .�12G�-- z .� 6l5 � <br />Owner/Authori ed Agent Signature Date (Revised 3/2013) <br />