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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLERIDEMOLITIC,N <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />Baal ICATION9 ARE ACCEPTED FROM 8 AM TO 4 PM r , 1 oC 6r, -f/V� <br />SITE ADDRESS: 35%O rci>f,-5 5.A,.-zf "A PROPERTY TAX PERMIT# <br />LEGAL for new construction: Short Plausubdivis1o;3Lfq 12 — 6O4 _Lot No. _�L (attach copy of long legal description) <br />OWNER j,� (_LC.- Phone/Email r6.)5-7yyY):'y� <br />Address Po ept l.i I' L Ciy/Slatelbp n ; r e •,e A ?:FYp Z <br />APPLICANT: iOm. er Owner's Agent _Contractor Contractor's Agent Tenant lmust arovbeebrsrarcomem kamma comerm dowoamma spaul <br />CONTRACTOR <br />L & I Lic. # COE Bus. Lic. # <br />Address,rvkrS Phone/Email <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas f Electric_ Other_ <br />Building type: N)�. 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 />Air L~: � F R — &sll c LA 2'4 <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: )New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Type or Project: _New_Addn _Alteration —Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Toilet <br />Forced air systems <br />Bathtub <br />Gas piping <br />I Lavatory (wash basin) <br />Water heater <br />i Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />k <br />Gas range <br />Dishwasher <br />k <br />Clothes dryer <br />Clothes washer <br />j <br />Range hood <br />Exhaust fan <br />t hea r <br />Sink (service/bar/mop/etc.) <br />Heat pump <br />Backfiow preventer <br />Unit heater <br />Urinal <br />Drinking Fountain <br />Boiler <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER i SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />1 hereby ceniy thal I have read and examined this application and know the same to be true and waect. Aa provisions of laws and ordinances governing NU type of work w fl be complied <br />with whether specified main or not. The granting of a permit does not presume to give suthonly to violale or cancel Ole prevision of any other state or local law regulating construction <br />That lam authorized y the owner of 013pert' to perform the work for which appl �egon 6 ads and I comply wsh the State Contractors Law 16.27 RC W and 296.200A WAC. <br />i <br />Owner/Authorized Agent Signature if Da a (Revised 612012) <br />I(z <br />