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� � <br />PERMIT APPLICATIOIV <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: PROPERTY TAX ti P MIT # <br />� .3C' (�" �, �; � �r��� �^� N �;�._ � �-`� �"�- �' �' �E3 r 1 a'-I �L`�'-� ;�'�'�C ' ��� � � � � - �,' �li' ? <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER � . �,1���� - Phone/E-mail �;�'�- -�� `j �� l _�� <br />Address ,' '�j�' . (� _ �--,(� _ -. � �� City/State/Zip 'l�'�%p�v;L,�l .� l,l._� � �"1 `��-�!;' <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor�5 AgBflt _ TBIlBflt (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR <br />State Lic. # <br />Citv Bus. Lic. # <br />Address Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />�ei t� �y�z�_ �tz � - • � �y.-������; <br />Phone/E-mail il�l��.- � �t� (�-_G irv��� cL�_.C'L�v� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building �� Q y)�¢1� 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 bad�) : <br />� � �. 1 <br />���r4-� �'�V�\cA`�� �7 t �� - <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 />Gas fireplace <br />! Gas range <br />; Clothes dryer <br />� Range hood <br />� Exhaust fan <br />� Heat pump <br />_� Unit heater <br />Boiler <br />i Refrigeration <br />� Woodstove <br />I Ductina <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />,� , , . �' M �-X �� i r� �� � �v�.+ �fi- <br />,; � <br />�o ic�._ L%�� <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />! Toilet <br />Bathtub <br />j Lavatory (wash basin) <br />j Shower <br />Kitchen sink & disposal <br />! Dishwasher <br />Clothes washer <br />j Water heater <br />I Sink (service/bar/mop/etc.) <br />; Backflow preventer <br />I Urinal <br />i Drinking Fountain <br />I Floor drain <br />I Grease trap <br />'� Roof drains <br />j Medical Gas <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 wheiher 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 of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br />� �. — <br />r- <br />�i , I --� <br />i � r � ��'�1 �, � b ���, � <br />Owner/Authorize Agent Sign3lture Da e (Revised 3/2013) <br />