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PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-3810 FAX 425-257-8857 www.everettwa.org <br />in n// In'/ — nit .-/n I <br />-y r v'/ <br />PROPERTY TAX #1 PERMIT #' h O` <br />SITE ADDRESS: 2 V <br />J J <br />LEGAL for new construction: Flailsubdivision <br />Lot No._ (attach copy of long legal description) <br />�Short <br />OWNER ` /(/� .:7 Phone/E-mail <br />/ 9 � <br />Address 2 r� > • - <br />it IS1ale2ip <br />APPLICANT: _Owner _Owner'sAgent Contractor _l.Con-tractors Agent L Tenant(must proade a letterer comentfrom Ne"mrlo do worlm the space) <br />L �x, h I r" Slate Lic. # tGGELJ12G-k' City Bus. Lie. # <br />CONTRACTOR <br />Phone/Email <br />Address <br />TENANT <br />CONTACT FOR PERMIT <br />�BUSINESS <br />�NAME / '/ / Y�1 /l <br />f�� UA�j �7 14 b447e/W Zr-� <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />HEAT SOURCE: <br />Use Building <br />Existing of <br />Gas_ Electric_ Other_ <br />Proposed Use of Building <br />✓Commercial <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi <br />-Family <br />of Use <br />T.I. Sign <br />Type of project: _ New Addition _ Remodel _ Repair __ <br />_ _Sprinkler .De <br />DESCRIPTION OF WORK (additional space provided on the back): <br />DESCRIPTION <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: <br />Alteration —Repair <br />Typo of Project: _Now,_Addn <br />_Alteration_Repair <br />_Now_Addn <br />Shaw <br />Number (#) of fixturesShow <br />Number (#) of fixtures <br />A/C — airhandlingunits <br />I <br />Toilet <br />Forced air systems <br />Bathtub <br />Lavatory (wash basi n) <br />Gas piping <br />I <br />Shower <br />Water healer <br />I <br />Kitchen sink & disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />I <br />Clothes washer <br />I <br />Clothes dryer <br />I <br />Water healer <br />Range hood <br />Sink (service/bar/mop/etc.) <br />y <br />Exhaust fan <br />Backgow prevenler <br />Heat pump <br />I Urinal <br />Unit healer <br />Drinking Fountain <br />Boiler <br />I Floor drain <br />Refrigeration <br />I Grease trap <br />Woodstove <br />Roof drains <br />Ducting <br />Medical Gas <br />Other <br />I SUPPRESSION SYSTEM <br />SPRINKLER <br />Other: <br />Number of Heads <br />Other. <br />I hereby candy 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 veil oe comPeeo <br />With whether speci0ed herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision of any other stale 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 18.27 RCW and 296.200A WAC. <br />(Revised 312013) <br />Owner uthorizod Agent Signature Dale <br />