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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 />c ACCSPTED 5:G0M It AM Tn a PM <br />PROPERTY TAX # PERMIT # <br />SITE ADDRESS: <br />lO <br />LEGAL for new construction: Short Plat/subdivision -Lot No._ (attach Copy of long legal description) <br />r� <br />Phone/E-mad <br />OWNER--/�i� /v/n'`s v„l'/\l <br />/ �S �% r v� w <br />Address r <br />c <br />CilylSlate/Zip ,c-VEWE711,V 14 <br />APPLICANT:_ Owner _ Owner's Agent ontractor Contraclois'Agent _Tenant (must prcvices ktwrameroem rum the owner to dowork in thespace) <br />,, I <br />CONTRACTOR T-S 77( ' D/v�� T� L & I Lic. # A 9T�SCt ,iy7 COE Bus. Lic. # <br />'!/1 <br />Address Phone/Email <br />��' �X �� Coi1J/(Jig <br />TENANT BUSINESS NAME CONTACT FOR PERMIT /I/VT'51-1% X11CS <br />���T' 'ao elic, US <br />Phone/E-mail /i JCj <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building UF)/"(]J/� % HEAT SOURCE: <br />:::Gas_ <br />ElectricOther__ <br />Proposed Use of Building �i%/t'Yf / <br />Building type: _Sin le Family Duplex_Townhouse _,Multi -Family _Commercial <br />Use <br />Type of pro'ect: i/New _Addition _Remodel _ Repair _ T.I. _ Sign Sprinkler ✓ Demolilion_Change of <br />DESCRIPTION OF WORK (additional space provided on the backkk���O�T <br />/J�ir�cu171ON UFEx/S7/AA, D/Lflrti�A/6�1c ///��fff� <br />f'D�7-SmK�7u�� �JZ2 <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION j <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 />Lavatory (wash basin) <br />Gas piping <br />Water healer <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer w•� <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Water healer <br />Sink (service/badmop/etc.)' <br />Range hood <br />Exhaust fan <br />Heat pump <br />Backflow preventer <br />Urinal <br />Unit heater <br />Drinking Fountain <br />Boiler <br />Refrigeration <br />Floor drain <br />Crease trap <br />Woodslove <br />Ducting <br />Roof drains <br />rdedical Gas <br />Otller: <br />Other: <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />I hereby wddy that I hevo read and examined this application and know the same la be true and Correct. WI provisions of laws and ordinances govmning this type of work wii be complied <br />with whether spedrred herein or not. The granting of a permit does not presume to give authonty 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 wth the Slate Contractors Law 1e.27 RCW and 296 200A WAC. <br />(Revised W2012) <br />ers <br />Owne'l lhorize Agent Signature Date <br />r <br />