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0 <br />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: <br />�1Cr�(G t`i d�S� il t �F� <br />PROPERTY TAX q <br />2b CS I500 gO51 G�0 <br />TPERMIT # <br />— (� <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER C,;o <br />Address 57 Z / "lcF.-i TL►3 ,� �Ct Fit; <br />Phone/E-mail SC-PF CC ,V1 <br />City/State/Zip 1�—iJLiL_A10 t 'IA Clc- C3 ^ <br />APPLICANT: Owner Owner's Agent Contractor Contractor's Agent Tenant (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR Sc A CO�J L-LC <br />L & I L. # sc=AwL *0 (? R-7j COE Bus. Lic. # 03 313 <br />3 <br />Address 1(05 <br />Phone/Email <br />TENANT BUSINESS NAME <br />Pg,c.M.lt tz- Sir S i ®2> t <br />CONTACT FOR PERMIT &jZ_TC g e&�:,E <br />Phone/E-mail UZ S- (S 37 - C/ `7,2U Gtt Sit SCJ�W �' i L� <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK 60 ACC <br />Existing Use of Building J iy fyj—, 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 />+x A16 XJSij°9C oAcOOrJAL-✓3S j�v��Z IJo ►.iC� <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: <br />Show <br />New _Addn _Alteration _Repair <br />Number # of fixtures <br />Type of Project: <br />Show <br />New _Addn _Alteration _Repair <br />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 <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 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 />Owne Au rized Agent Signature Date <br />CC M <br />(Revised 612012) t/L <br />