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• • <br />����0� ������� r ��� <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.orq <br />� .0 �� � <br />SITE ADDRESS: � PROPERTY TAX # PE MIT <br />��, � '-° . . ��_ -� ��. ������i . <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER 5 � (, k� c:� �,�? Phone/E-mail � LJ - 7i � - �� � � �i J � �.SC _ < <br />Address ^� —��� Q S� City/State/Zip � p�� <br />APPLICANT: � Owner _ Owner�S AgBflt _ COf1ff2CfOf _ C011tteCIOf�S Ag0f1t _ T@ll8flf (musl provide a lelter of consenl from lhe owner lo do work in the space) <br />CONTRACTOR �� ��� State Lic. # Cify Bus. Lic. # <br />., <br />Address PhonelEmail� _ _ � <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />�.Z� . �al - 3"3�1 1,, <br />Phone/E-mail �''S m�I� C` I GJ �� (,.S' L' ��.0 <br />BUILDING PERMIT APPLICATIOIV CONTRACT PRICE OF WORK SI%� , <br />/'� � �, w i HEAT SOURCE: J`�� /y <br />Existing Use of Building - � � �� , <br />Proposed Use of Building `�? _ Gas_ Electric_ Other_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family y Commercial <br />Type of projecl New Addition � Remodel '�, Repair T.I. Sign Sprin{<ler _Demolition_Change of Use ___ <br />DESCRIf�TION �F WORK (additional space provided on the back) : <br />#-�nGlri�) ; t�'���.�5 :���:��.,�.�.s.�. I �jGc_�s���� <br />i <br />MECHANICAL PERMIT APPLICATION , PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures � Show Number (#J of fixtures <br />A/C — air handling units i ' Toilet <br />� Forced air systems � Bathtub <br />� Gas piping � Lavatory (wash basin) <br />� Water heater � Shower <br />� Gas fireplace � Kitchen sink & disposal <br />� Gas range I Dishwasher <br />� Clothes dryer � Clothes waslier <br />� Range hood � Water heater <br />Exhaust fan ' -�---�- � Sink (service/bar/mop/etc.) <br />Heat pump � Backflow preventer <br />� Unit heater � Urinal <br />� Boiler i Drinking Fountain <br />� Refrigeration ! Floor drain <br />� Woodstove � Grease trap <br />� Ducting � Roof drains <br />I Other I Medical Gas <br />SPRINKLER / SUPPR��S18F1 �i�YEiVi I Other. <br />INumber of Heads I Other: <br />I nereby certify that I have read and examined ihis 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 authoriry to violate or cancel the provision of any other state or local law regulating construction <br />That I am authorized by the owner of lhis 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 />� , lz <br />� �� :�"._-= " ; `; , . , <br />�-- <br />c�. _. <br />Owner/Authorized Agent Signature Date (Revised 3/2013J <br />