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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 />SITEADDRESS: ' �'� IPROPERTYTAX# <br />i 7 �� ,�1� G� l�-/ � <br />PERMIT i� <br />�� , -� <br />. `-r- � � - <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER ��'j�/^ 1 " �' aJ -� �%'`T � S l�-- Phone/E-mail p`f�% , � � (r� — .�� S <br />Address �D ;.; " � City/State/Zip s/� v�(U�2! �S � �� ��j ��� <br />APPUCANT: Owner _ Owner's Agent _ Contractor _ Contractor�5 A9@flf _ T2f18f1Y (musl provide a letler of consent from the owner to do work in the space) <br />CONTRACTOR y1,�-�G-�� � l�v d� f� {� <br />Address <br />TENANT BUSINESS NAME <br />BUILDING PERMIT APPLICATION <br />Lic. # <br />Phone/Email <br />Citv Bus. Lic. # <br />ONTACT FOR PERMIT �I 1C,�.Y,,��l LI�-Y <br />�/ TT <br />ione/E-mail Z�iL �? cp 3 Z�S /�"L2fY�1( <br />ONTRACT PRICE OF WORK `-�"`- iO��i, <br />Existing Use of Building /'7'h Gw `7-I'�'�'"�'� � <br />Proposed Use of Building Jl/ {� C���-`� � <br />Building type: _ Single Family _ Duplex _Townhouse � Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) :,/�C�C�� �'� �� vy <br />• /T 0 <br />�-r �-� � �>>� �� -���.�-�- . . _ <br />i-������-�- <br />��-� �e. �2 �c��,S' �t ��-�� � <br />HEAT SOURCE: <br />Ga <br />Othe <br />�- � C c�H <br />�f) <br />Demolition Change of Use <br />�� � �r��v✓��� 115�� <br />�� �v �� <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />pe 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 />i Unit heater <br />—� Boiler <br />! Refrigeration <br />I Woodstove <br />I Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />! Number of Heads <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />' Bathtub <br />; Lavatory (wash basin) <br />; Shower <br />! Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />� Water heater <br />; Sink (service/bar/mop/etc.) <br />� Backflow preventer <br />I Urinal <br />i Drinking Fountain <br />! Floor drain <br />I Grease trap <br />Roof drains <br />i Medical Gas <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 will be complied <br />with whether specified herein or not. The granting of a permil 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 1827 RCW and 296200A WAC. <br />� � �- <br />��� � 2- " '�L <br />Owner/!�f rized A nt Signature Dat (Revised 3/2013J <br />r <br />