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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: PROPERTY TAX# PERMIT# <br /> (015 - Est- <br /> S' SE 1 1 � 3C 'C'I _, <br /> LEGAL for new construction: Short Plat/subdivision "�DEE �'1'11i l��C� Lot No. (attach copy of long legal description) <br /> OWNER -EQAe- 1��C11p�,_-7CDl.1Dp 11o�r Phone/E-mail 20."114. o5g11 0 ��orle—\rV%Wl(,.00 <br /> Address �. FV12 1 City/State/Zip � � � 95ZD(o <br /> APPLICANT:—Owner -x Owner's Agent {-Contractor Contractors Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR t Q L yLO ns C ) L& I Lic.# COE Bus. Lic.# <br /> Address '`�f' vn Phone/Email <br /> TENANT BUSINESS 4N�ArME�J / CONTTA���C(,TT FOR PERMIT <br /> O tlrc�lNCX k 1 ��a(' Phone/E-mail 45e) —n1—7 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 150, 0 <br /> Existing Use of Building 'P_ESVQCA.�,Al, HEAT SOURCE: <br /> Proposed Use of Building "t tlixV,l lA4l Gas Electric_ Other <br /> Building type: _Single Family _Duplex_Townhouse Y 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): 1 <br /> ILE�PA\1Z UIJ.C12.ETU- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other ; Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM j Other: <br /> Number of Heads Other: <br /> I hereby certify that I have rea ned 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 sped in or not.The gr ting 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 authori d the wrier of this prop 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 /> l� <br /> Owner/Authori d Age ign Lure Date (Revised 6/2012) / <br />