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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 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS:© -r <br />(C�C�fv ICIAVE SE_ �--v&-t"i <br />PROPERTY TAX# <br />Z&05 I80OZ/OSloo <br />PERMIT # <br />—OJ <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER ,2e_r'Vt S:Y77rV-E eV T <br />Phone/E-mail i_i c <br />Address 572et t-dAlcE0TC, Z ►. 6 #"R66..J6'lQ- <br />City/State/Zip oA 96o <br />APPLICANT: Owner Owner's Agent ___X Contractor Contractor's Agent Tenant (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR 091" Cc) AL-,t6 1 ' <br />L & I Lic. # 30UA,L143 1 FL Cs, COE Bus. Lic. # OZ 6Jq <br />Address 1220 <br />Phone/Email <br />TENANT BUSINESS NAME <br />�nSL�2 -SC.�r Si cnAG C- <br />CONTACT FOR PERMIT E12EESC_� �� Ccr <br />tl LC- 911� <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK 100 000 <br />Existing Use of Building %I/c <br />HEAT SOURCE: <br />Proposed Use of Building 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 space provided on the back): <br />C`c:+�Si �t-lam A� 3o PZLC. S© -016T— PILE ZCTA tJ:,%JG t AL L- joEZ AlT►>c"Eo <br />S�(,lC �ini1AL � iZt�iJ,�„�-1GS . <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _NewAddn <br />Show <br />_Alteration _Repair <br />Number (#) of fixtures <br />Type of Project: _New <br />Show <br />_Addn _Alteration _Repair <br />Number # of fixtures <br />A/C — air handling units <br />Toilet <br />Forced airs stems <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 />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER <br />/ SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby certify 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 will be complied <br />with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I am authorized by the ner his 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 />f E W10 / Z <br />Owner/Authorized Agent Signature D to (Revised 612012)� <br />