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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# PE MIT <br /> �� —����u ''�'�%'�; ��'`1�I.���'Sui �'�'�? Q�-- OZ�`� <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER � C�(,�"� ��l)'�'��� ���{�Il� Phone/E-mail �1.�`Z���} ��`1 ��� c)��t-�r.J�'��C1�11�1��j�'t���^��,�C� <br /> Address 3���,� ,��j 1 ��1.. � ��L� City/State/Zip ����S�� ��- �`Yj C, 7�� <br /> APPLICANT:_Owner _Owner's Agent �Contractor _Contractor'S A9el1t _T2118�L(must provide a letter of consent from the ovmer to do work in the space) <br /> � �� . <br /> CONTRACTOR �iC h� ti$ C��--��'lf�' State Lic.#�-���l�C� I� LC>��.� � City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> ��v�t N ct c.�c�: Lj 25— 2`t c-7 zy L I <br /> Phone/E-mail G('l '� C�c�C�( � t��+�"�1�'Oj . C��.^/1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �j� :3 ;U��C <br /> Existing Use of Building S �'� HEAT SOURCE: <br /> Proposed Use of Building ��� Gas Electric Other <br /> Building type: �Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> T pe of ro ect: New Addition Remodel �`° Repair._____T.I. Sign____Sprinkler_ Demolition Chanqe oF Use <br /> DESCRIPTI�N OF WORK(additional space provided on the bacl<): <br /> �tr '�t^vOl'" � ��t�,�,- ��-' ��it,' j ;:d;.� l� ��:i ;r;,�:, �'�A �° d�C- tiit.x-i��v <br /> n /'�, � <br /> (_-;: lr.,y.— ]"l,�✓ (�, F��'' -�r-:a e- �, ��ei�•�.�.4� � ^ , <br /> -- - - .... � � - --� <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(#J of fixtures Show Number(#)of fixtures <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 � Dishwasher <br /> I Clothes d er � Clothes washer <br /> I Ran e hood I Water heater <br /> i Exhaust fan ! Sink service/bar/mo /etc. <br /> � Heat um I Backflow reventer <br /> ! Unit heater Urinal <br /> i Boiler � Drinkin Fountain <br /> � Refri eration i Floor drain <br /> j Woodstove ; Grease tra <br /> j Ductin ' Roof drains <br /> � Other � Medical Gas <br /> I <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 goveming thls type of work will be compl <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 pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br /> P � � <br /> ner/ uthorized Agent Si ure Date (Revised 9/2014) <br />