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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 vrvvw.everettwa.org <br />' !� 4T— <br />PE ITx <br />LEGAL for new construction: Short PlaVsubdivision Lot No._ (attach copy of long legal description) <br />OWNER ZE/I�QL � <br />Phone/E-mail 4Z� 1jT22—?itZ <br />Addresses/,� (,v 4S[ LL 4, <br />�7 ? <br />CilylSlalolZip L.7� <br />.4PPLICANT:�owner Owner's Agent _Contractor Contractors Agent _Tenant )mu;tpmKdoate::ar al ccnsen:'•om ma owreno do worm me spaw) <br />$LLL <br />CONTRACTOR -?- %�-� — �G L.Lat,.B <br />ity <br />State Lic. # Bus. Lie. <br />�# <br />Address Phone/Email � "(/Q <br />TENANT BUSINESS NAME <br />l= vE N L'f'?" t'%D 1.7 C Y!D 9'f-Y 1)1 L <br />CONTACT FOR PERMIT <br />/lJI���ZS1�k22— ZZlZ7 <br />PhonelE-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OFWORK Q9D^ <br />Existing Use of Building 1� E'-Tfi-ZL HEAT SOURCE <br />Proposed Use of Building�Sd Gases 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 space provided on the back): <br />L/,1�7--fl-LG sb' >c S`b' nQy RD7JZ= <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (ll) of fixtures <br />Typo of Project: _New _Addn _Alteration _Repair <br />Show Number (+Y) 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 />I 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/mopleft.) <br />Heat pump <br />� Backgow preventer <br />Unit heater <br />� Urinal <br />� <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />� Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />� <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER /SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />� <br />Other: <br />SITE ADDRESS: <br />PROPERTY TAX <br />I hereby certify that I have lead and examined this application and know the same lobe true and correct. All provisions of laws and ordinances governing this type of work wit be compred <br />with whether speci0ed herein or not. The granting of a rental does not presume to give authority la violate or cancer the provision of any other state or local law regulating wnstruction <br />dt5m�'-ho,i, authonzed ey the c er of I ' ropany to penomn Inc work for whiUr application Is made and 1 comply with the State Confra[tors Law 1e.27 RCW and 296.200A WAC. <br />11Agont Sig atura ate (Revised 312013) <br />