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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 /> SITE ADDRESS• PROPERTY TAX# P��'�i.T# <br /> �� � i� '��, � :�:s� vc� � �c�es��� i�co �� — UI <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER �C���C (�(�-�-h��� �o'Y►�?S Phone/E-mail -TL�"Z�(� � �`'(Z.�l J�L��hcrCickb�<<-►�E'r'i,cc'�� <br /> Address ���L2. ��+y �Q� /�.� City/State/Zip � � S��(`� �-��, �L�� �� <br /> APPLICANT:�Owner _Owner's Agent _Contractor _Contractor�S A9@f1t _T0f18f1t(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR �• ��� F����h�'� �"�`�'�is State�ic.#N�k��k Q���'�z-��. City Bus. Lic.# <br /> Address ��b�`C C�5 C�4jd�'� Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT 'K���ncIC�CLJ��`��'�'�T<<�'''�`'� <br /> ��� � <br /> �..� ��cA t►-. J <br /> Phone/E-mail �Z�'Z�r�`Z �Z�y <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �?� �l c. <br /> Existing Use of Building 5 1`� HEAT SOURCE: <br /> Proposed Use of Building S�`1� Gas Electric_ other <br /> Building type: �Singie Family _Duplex_Townhouse _Multi-Family _Commercial <br /> T e of ro ect: New �Addition �Remodel ,�Repair T.I.r� �Si n S rinkler Demolition Chanqe of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): ' I r� ��(�(.CL I�-�-f'��— <br /> ���c���{n��� I 2 �l�,y�n���� � clr�vUG{.� ( � <br /> �l��%✓ GL" �l'}�t( T��1 <br /> r''�1�� C f� .���'V��C J1 l�� �(�A V"t�J i � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration�C Repair Type of Project: _New_Addn _Alteration�Repair <br /> Show Number(#)of fixtures Show Number(#)of fixfures <br /> A/C—air handlin units Toilet <br /> Forced air s stems / Bathtub <br /> Gas i in Lavato wash basin <br /> / Water heater � Shower <br /> Gas fire lace / Kitchen sink&dis osal <br /> Gas ran e f � Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood <br /> / Exhaust fan Sink service/bar/mo /etc. <br /> � Heat um � Backflow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> � Ductin Roof drains <br /> Other � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM ( Other: <br /> Number of Heads Other: <br /> I hereby ceriify 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 compl <br /> with whether specifed 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 /> Th I auth 'zed by th o ner�f this property lo perform the work for which application is made and I comply with the Slate Contractors Law 18.27 RCW and 296.200A WAC. <br /> �,�. �� 2-- 2 � -ts� <br /> O ner/ thorized Age t ig ature Date (Revised 9/2014) <br />