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PERMIT APPLICATION �11 JUL i 72013 U <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLEgh5i�-IVt6L41G7[WS <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: � n � � <br />PROPERTY <br />LEGAL for new construction: Short Plat/subdivision <br />Lot No. (attach copy of long legal description) <br />OWNER q— E*,C <br />Phone/E-mail <br />SIL3 Address U j <br />c <br />Q ty/State/Zip ` j ', Ig <br />APPLICANT: Owner Owner's Agent _ Contractor <br />Contractor's Agent Tenant (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR <br />L & I Lic. # Cam. �1O J\`QS COE Bus. Lic. # 7 <br />f. <br />Address Vt5 S GC; S I ` <br />A J�Xs <br />( <br />Phone/Email <br />TENANT BUSINESS NAMES <br />CONTACT FOR PERMIT ✓ <br />�Mmiec- s-+o <br />CZcG�� q' <br />Phone/E-mail - J <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Buildir.��(tl <br />HEAT SOURCE: <br />Proposed Use of Building (- <br />Gas Electric Other_ <br />Building type: Single Family _ Duplex _Townhouse <br />Multi -Family Commercial <br />Type of project: New Addition Remodel Repair _ T.I. X Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />S fiai� ��t�l s'��c�S , G� ne I (vim►oa'w' Set of c(lno,�n� 1)LQ cS Jo r� <br />,�� ,Mk"0&0- e�' �fi I �� <br />t t <br />C1 O � c� O t14 t1 �«J�r+�t n��e �+ G 1 v� c� tc <br />5 c <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: New _Addn _Alteration _Repair <br />Type of Project: New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <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 />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 / 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 specifi 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 />Th?t I am a zed 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 />.C< <br />1��KaA) -1 /�51 'IL <br />Owner/Aut orized Agent Signature Date (Revised 612012) <br />