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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 />SITE ADDRESS: PROPERTY TAX # PERMIT # <br />_[� Z� Li,Ns�-������� .S�- a� �E� � Z� � �,�c� z 5�� �15��- �.� <br />LEGAL for new construction: Short Platlsubdivision Lot No. (attach copy of long legal description) <br />OWNER ���Q.i.k �r���'�NJS ��1C.rb�l� Phone/E-mail��S'Z.�U_"Z�Z.y �c...�'��.J%1Q�1C��lG�'fif�(f <br />Address , � � � �, � `�,% �'C CitylState/Zip t y tC��r S r: '� ��' (,� � � Sj �L 7C? <br />APPLICANT: Owner _ Owner'S Ag@nt _ COflt�8Ct0� _ COnt�Bcto� s Agent _ T2nant (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR �jC.� vh� Cj, }' (j �..� p'� �"' State Lic. #��(.\�1� j�'.�{j[ ;� I) �7 City Bus. Lic. # <br />BUILDING PERMIT APPLICATION <br />Phone/Email �Z,S'2�1� Zy Z� <br />FOR PERMIT • ��i ��C�C " <br />�J <br />i ��:� `C`�l� Gl GL C1� y ��.}-� ('`"S. Ct.>.� <br />f PRICE OF WORK <br />Existing Use of Building 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 />'�'v'� L 1 i S �l ��X; ��-�-; v�c� ��' �c ✓� � La e�-� c� t t' �- <br />��i�`— .�C,�.'� 1 <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br />Show Num6er #) of fixtures Show Number (#) of fixtures <br />A/C — air handlin units Toilet <br />Forced air s stems Bathtub <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes d er <br />Ranqe hood <br />Unit heater <br />Boiler <br />Refriqeration <br />Other <br />SPRINKLER / SUPPRESSION <br />Number of Heads <br />TEM <br />Lavatory (wash 6asin <br />Shower <br />Kitchen sink & dispos <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/moF <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be true and correcL All provisions of laws and ordinances goveming this rype of work will be comp. <br />with whether specified herein or n. 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 construction <br />That I autho d by the er this property to perform the work for which applicafion fs made and I comply with Ihe State Contractors Law 1827 RCW and 296200A WAC. <br />�����\�;,\� �� - � 2 ► � <br />Date (Revised 9/2014) <br />