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NERMI�' APPLICATIO� <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EV�RETT 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 />:2' � � a �v��'t� 1/�-' t? �' d 1 ' ,� C� ! D � ' D b (o <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNERS 00 /— r-� i�i � � 1%i/7 � Phone/E-mail SJ`�s "�3'("��'�C' �rQ�lt�l' `.�.Ai�,$' CG'!Y y/•�•k. <br />7 .+� l�`' <br />Address j% s�� �'� �/'f•• l rY � City/State/Zip C�"�S''��I �z//� �� <br />APPLICANT: �Owner _ Owner's Agent _ Contractor __ Contractor'S Ag@flt _ T@I18flt (must provide a letler of consenttrom the owner to do work in ihe space) <br />CONTRACTOR�' a�/C% � y � � L C` state �ic. #6G-N �M� G�-l� S S � c�ty Bus. u�. # � 539 � <br />Address SS ~' �'ljCr� � p� �p Phone/Email .�j`��/ �= � jj r v�, <br />TENANT BUSINESS NAME CONTACT FOR PERMIT .���T <br />c� 9' 6.3�,�. .Z 9 a o �0.� f'/"7'' C- ac%Gc� /%� <br />Phone/E-mail ' �j Z`� c- �_ �jT�;/F ryr( ij � <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />F�cisting Use of Building ,���h e� HEAT SOURCE: <br />Proposed Use of Building ✓I!� �t� L-'�n�71 �as Eiectric other <br />Building type: _ Single Family � Duplex _Townhouse _ Multi-Family _ Commercial <br />T e of ro�ect: New Addition Remodel Re air T.I. Si n S rinkler Demolition Chan e of Use <br />DESCRIPTION OF WORK (additional space provided on the i5ack) : <br />\ <br />i �( <br />f �:� y i� � � G) �J (, � .)� /� <br />l I <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: 7�New _Addn _Aiteration _Repair Type of Project: �New _Addn _Alteration _Repair <br />Show Number (# of rxtures Show Number # of fixtures <br />AIC — air handlin units „ Toilet <br />Forced air s stems ' Bathtub <br />Gas i in Lavato wash basin <br />Water heater Shower <br />Gas fire lace Kitchen sink & dis osal <br />Gas ran e Dishwasher <br />Clothes d er Clothes washer <br />Ran e hood a <br />Exhaust fan Sink service/bar/mo /etc. <br />Heat um Backflow reventer <br />Unit heater Urinal <br />Boiler Drinkin Fountain <br />Refri eration Floor drain <br />Woodstove Grease tra <br />Ductin ' Roof drains <br />Other Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEMI Other: <br />Number of Heads 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 compl <br />with wheth �'specified herein or not. The granting of a permit does not presume to give authordy to violate or cancel the provision of any other state or local law reguiating construction <br />t I am uthorized by the ow r of this p perty to perform the work for which application is made and 1 comply wRh the State Contractors Law 1827 RCW and 296200A WAC. <br />�l � _�z_,� �;Z <br />'�Owner/Authorized Agent Sig r Date (Revised 9/2014) <br />. <br />