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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# MIT# <br /> — ^���u� '�l,}l: ��"15i �'�?5U1 �L�� � rv� �` <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER �,� ��L'-�'1�'� �'7c,1'{�� Phone/E-mail 2�`Z IO �2`i Z�� J�-'������UQ(.�1��j�'ti Y�r'(,�. <br /> Address .,�jC�2� � 1 ��'�. �riL� City/State/Zip ����S�' ��= ��Yj C. 7� <br /> APPLICANT:_Owner _Owner's Agent X Contractor _Contractor�S A92nY _T211811i(must provide a letter of consent from the ovmer to do work in the space) <br /> CONTRACTOR 5C' -�� 4$ C��-�b1ti'�r' State Lic.#�-�t,�lU;�l �j TC'�;�� � City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> R��t I�cit�ci� �2,��- 2`fc�- ZyL � <br /> Phone/E-mail 1 �.%�'� �� CZ C�(�� � +:�l�{����j , (�1.�✓1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � 3 y(���G <br /> Existing Use of Building S ���' HEAT SOURCE: <br /> Proposed Use of Building 5[� Gas_ Electric Other <br /> Building type: �Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> T e of ro�ect: New Addition Remodel Re air T.I. Si n S rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(additional space provided on the back) <br /> __— ..— ._ . r <br /> --z' a-� �wtyr=��=t���.."�i�����—��--��t1�L ,o_ .�.i�L'Tl1.�:�: r <br /> !` � ^ .- 'i <br /> �--�...:- - _� ���a v G C. u��u�� �.�� ���i <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 fi�rtures <br /> A/C—air handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas i in Lavator wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink(service/barlmo /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 certrfy that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances goveming this type of work will be comp <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 authorized by the owner o his p perty to perform the work forwhich application is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. <br /> � � <br /> ner/ uthorized Agent Si ure Date (Revised 9/2014) <br />