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�RMIT APPLICATIO <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLI`►�ON <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:� r' /_ �G��' �L�, T,� I/C � I`"1 V e� <br />I lv <br />EGAL for new construction: Short Plat/subdivisi <br />NNER CIZrn� j; <br />dress �-, (0 2 � i.,(-',L e <br />'PLICANT: _ Owner _ <br />25�11�e�� <br />��� V� S� <br />Owner's Agent <br />PROPERTY TAX # � R IT # / <br />a o4������y 3�, ��y�y��: � l��i � <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail 7� L���1 ' ���� � ' <br />City/State/Zip ��-�LL�, L�il� �% �'�G� � _ <br />1 <br />Contractor _ Contractor�S A90fli _ TBf1811t (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR �y�-N �--L�' %��}� /niC� �,I- tl%L State Lic. #�!%1vrFi-� ��1JL I City Bus. Lic. # �y l�S� <br />Address o-=vC`4' 1G�%�-� 5�-- Sl�v .L{�/U� C..�/���%i�[�'� �J�� Phone/Email ��) �j l�- (,�� UU <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />BUILDING PERMIT APPLICATION <br />PhonelE-mail ���C�+-%1 � / i—� ���? �� � �� <br />CONTRACT PRICE OF WORK �Cv� � <br />Existing Use of Building <br />Proposed Use of Building Ga <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) : <br />HEAT SOURCE: <br />; Electric Other <br />Demolition Chanqe of Use <br />G�< <-i ��C�'�,Us��" �� ��.5 � � 1Zv�e.. -��a � <br />MECHANICAL PERMIT APPLICATION <br />TypQ of Project: _New _Addn Alteration _Repair <br />Show Number (#) f fixtures <br />A/C — air handling units <br />Forced air systems <br />� Gas piping <br />I Water heater <br />' Gas fireplace <br />Gas ranAe <br />I Clothes dryer <br />i Ranqe hood , <br />� Exhaust fan <br />Heat pump <br />' Unit heater <br />� Boiler <br />I Refrigeration <br />� ' Woodstove <br />I Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <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 & dispos <br />Disnwasher <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 ceriify that I have read and examined this appiication and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be compi <br />with whether specified herein or not The gran of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulaling construction <br />That I uthorized by t e wn of th pro ert to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />� � W <br />n,. e��rti.,.� e,.o., c�,...�r,�.o n�ro ino�,;�o.� aiomn� <br />