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PERMIT APPLICION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITI <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM & - O (4 -1 Z <br />PROPERTY # <br />SITE ADDRESS:, /` C � �/,/ ,r�; �`-I (:%� 02 %�OD� G1 Z %(� <br />PERMIT# <br />S 20 0 _ 002 <br />LEGAL for new�con"stmctiioon: Short PlaUsubdvvissiion______--__Lot No.___ (attach copy of long legal description) <br />OWNER 131 <br />Phone/E-mail <br />Address 1'71 0;-; ., ��_ A-w- N1 <br />City/State/Zip 29>,L01-ell <br />CONTRACTOR i^ SI Zvi 3L§Jeejlj <br />L &&II Lic. # / ✓lL4-7-Xia <br />Address O� }� {J (/�i I 1 �oy.�z71i PhonelEmail S %� <br />TENANT BUSINESS NAME <br />JJA'l A r <br />CONTACT FOR PERMIT . <br />Phone/E-mail G 577 3,f- <br />BUILDING PERMIT XPPLICATION <br />CONTRACT PRICE OF WORD i/37J <br />Existing Use of Building <br />HEAT SOURCE: <br />Proposed Use of Building I 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 spaca provided on the back) : <br />t*S tZU Olti? <br />Have you started working without a permit? _YES ! NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn — Alteration _Repair <br />Show Number (#) of fixtures <br />Type of Project: __New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C - air handling units <br />Toilet <br />Forced air systems <br />Bathtub <br />Gas piping <br />Lavatory wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink service/bar/mop/etc.) <br />Heat pump <br />Backflow preventer <br />Unit heater <br />11 <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodslova <br />Greasetrap <br />Ductin <br />Roof drains <br />Other___ <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />1 <br />Other: <br />I hereby certify that I have read and examined this application and know the sar..e to be true and correct. All provisions of laws and ordinances governing <br />this type of work wdll be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel <br />the provision of any other stale or local law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to perforw the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC 14 <br />n'- �%`-//, / Ow uthorized Agent Signature Dale (Revised 212011) <br />