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- a � � � <br />. <br />PERMIT APPLIC�4TION <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 />SITE ADDRESS: A <br />�-� � �� �V(�� ; N l�C; � l� �'_� j� <br />LEGAL for new construction: Short Plat/subdivis <br />OWNER :�c� �S� �C'�f�"'� <br />Address (�(� 1Z �S�i�V�r��'� �iJ � r� <br />APPLICANT�"c�r _ Owner's Agent <br />CONTRACTOR �}� � � /�/. <br />Haaress <br />TENANT BU <br />Contractor <br />f ��� <br />j��C�-!�M2 1�a2� , � LC. <br />BUILDING PERMIT APPLICATION <br />PROPERTY TAX # <br />��;� 5'�; � m' Z <br />IT <br />��� Lot No. (attach copy of long legal description) <br />Phone/E-mail ��IZS� � G j.%�(; � ,� c' Ssc't �1%tiF��('� Z� ',��, <br />City/state/Zip E(/�2� =t ��� � t �� Zp� <br />Contractor�5 A9211t _ Tef1811f (must provide a letter of consent from the owner to do work in the space) <br />State Lic. # <br />Phone/Email <br />hone/E-mail <br />ONTRACT PRICE OF WORK <br />Bus. Lic. # <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building 2'� I e• �� Gas Electric Other <br />Building type: _ Single Family _ Duplex Townhouse _ Multi-Family _ Commercial : <br />Type of projecY New Addition emodel Repair T I Sign Sprinkler Demolition ��hange of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />��r, ✓� r,~} �!] �'��� � r`� j��,L'�S� I`�hne:�l•L.f;-�s�c'� �� �"�J��/� �='i�l`C ��c,� r`t". ��),��� <br />� 4 <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />i A/C — air handling units <br />� Forced air systems <br />Gas piping <br />Water heater <br />I Gas fireplace <br />i Gas range <br />j Clothes dryer <br />� Range hood <br />Exhaust fan <br />( Heat pump <br />; Unit heater <br />� Boiler <br />i Refrigeration <br />; Woodstove <br />Ducting <br />� Other <br />INKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />Toilet <br />' Bathtub <br />� Lavatory (wash basin) <br />� Shower <br />j Kitchen sink & disposal <br />i Dishwasher <br />i Clothes washer <br />i Water heater <br />� Sink (service/bar/mop/etc.) <br />� Backflow preventer <br />I Urinal <br />i Drinking Fountain <br />� Floor drain <br />Grease trap <br />Roof drains <br />i Medical Gas <br />; <br />i 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 wiil be complied <br />with whether specified rein or not The granting of a permit does not presume to give authority fo violate or cancel the provision of any other state or local law regulating construction <br />That I am �ythorized the owner of this property to pertorm the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. ��� <br />/ <br />Agent Signature <br />Date <br />(Revised 3/2013) <br />