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PERMIT APPLICATIC : W <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 /> SITE ADDRESS: PROPERTY TAX# PERMIT# <br /> cccl PAz e 4 i s �1 A�fc I <br /> vev•t-�+-�wa �,e�v <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER r Phone/E-mail r u5 spy <br /> Address 3p5cp �' �Nd City/state/zip Oi2 77--,70,L <br /> APPLICANT: Owner _Owner's Agent _Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work in the space) <br /> CONTRACTOR _f/1 State Lie.# ((Orrj� t!. City Bus. Lie.# (p <br /> Address P— .1— )- ` � Phone/Email` D? 31cl c rr�i�G G Co <br /> CONTACT FOR PERMIT Mi VA,4.-4 Ili It � <br /> . <br /> 41- +J4 Phone/E-mail �;� :�i�' 7 r� •C.�" c'.,t�w+ <br /> BUILDING PERMIT APPLICATI N CONTRACT PRICE OF WORKG� <br /> Existing Use of Building'- <br /> uilding�(A L tai)' �b �/" "l t�V HEAT SOURCE: <br /> Proposed Use of Building �'tiLi4r/�tc[<s' F� t-� 1 <.�✓ Gas Electric Other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family -X-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 /> b i vt f�t�e Asa wu Co c-o-1, pv� . ' ` TJ PC 1- ftQ v? 7 6 eN f WW <br /> C�1 <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 I 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(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> i Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads 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 author' d 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 /> Awne/re/Authorized�ZQ <br /> Agent Si ature Date (Revised 4/2015) <br />