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�� <br />r� <br />L_e <br />PERMIT �4PPLIC/�TION <br />BUILDING/MECHANICAL/PLUM�ING/SIGN/SPRI(VKLER/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 />ITE ADDRESG• � PROPER �TAX # �a� <br />%�%l � ��//1/iE � Ci'� #/J C7Q :� � �L. L3 �� f��Ff .j O �� <br />LE%AL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OVUNER ��� :��T/ OL���i'V �j �G��' ,C� /,�, � Phone/E-mail � .� , G J �... � � � �- <br />.�7 �� <br />c <br />Address �� ���x� /J f City/State/Zip �v���� l��f' ��G,�%�J <br />PLICANT: ✓ Owner _ Owner's Agent <br />NTRACTOR L�/L%� <br />Contractor _ Contractor�s Ag8f1t _ TenBflt (must provide a letter of consent from the owner to do work in the space) <br />State Lic. # <br />Bus. Lic. # <br />r�uaiess Phone/Email <br />TENANT BUSINESS NAME �� �� � �,7� �? � CONTACT FOR PERMIT �� «--� <br />� ����� ��� �� <br />�!/���/ � � ���• L- �-� Phone/E-mail ����5 . �L��: � J �� ��f'✓��C" �1�� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �c���- �� <br />Existing Use of Building J '��. 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) : <br />���?/�f" c�- ���� ,�-�-1�'/�/' �/`��'l %��' � <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handlinq units <br />� Forced air systems <br />Gas piping <br />� Water heater <br />; Gas fireplace <br />� Gas ran e <br />Clothes dryer <br />� Range hood <br />� Exhaustfan <br />_ I-ieat pump <br />� Unit heater <br />3oiler <br />Refrigeration <br />Woodstove <br />Ductinq <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMET APPLtCAT10N <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />� Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/ba <br />Backflow prever <br />Urinal <br />Drinking Founta <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby ceRify that 1 have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this type of work will be compl <br />with whether specified herein or noL The granting of a permit does not presume to give authonty to violate or cancel the provision of any other state or local law regulating consWction <br />That I a on by t wn�r of this property to perform the work for which application is made and I compiy with the State Contractors Law 1827 RCW and 296.200A WAC. <br />� ��� f �fm <br />Uwner/Aut� z Agent Signature Date (Revised 9/2014) <br />