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� <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRIWKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8890 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERTY TAX if P IT _��U <br /> ��i ' ,_. �. C!v�..t�-{-� c.��t��i i>���o t �a� G , <br /> LEGAL for new construction: Short PlaUsubdivision ___Lot No. (attach copy of long legal description) <br /> OWNER �'�� � `� � � Phone/E-mail <br /> Address(���(5{'� � � - Y-./� �•�� '� City/State/Zip � ;� „� � j�- C� <br /> APPLICANT:_Owner _Owner's Agent �COIllfBClOf__CO(Itf8C10f S A9@Ilt __TBf18�Y(must provide a letter of consent fmm the owner to do woric in[he space) <br /> CONTRACTOR� �, � - State Lic.#�{� L:�1 �7�" �, City Bus. Lic.#� � S C <br /> Address N C �5�r� � ' ��.,� C,f��(��L� Phone/Email �)-��SS���� �� r?t5�G'�S1' Lt 1�.' ' „�Gi1 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT ' <br /> � cc �s � �fie. ��em � IC- , .�� ��e,�-� _ <br /> Phone/E-mail L.� � � ��j ) „ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building ______ ___ HEAT SOURCE: <br /> Proposed Use of Building_ _________ Gas_�_ Electric__ Other <br /> Building type: ___Single Family __Duplex_Townhouse __Multi-Family _ Commercial <br /> T e of pro�ect: New _Addition � Remodel Re air_T.I._Si n_._S rinkler__Demolition__Chan e of Use <br /> DESCRIPTION OF WORK(additiona!space provided on the back): <br /> �1�C'_Y� C�Yl��.1'1�.G'oCtk� <br /> .����u�j�n� <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 Lavato wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchien sink&disposal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink service/bar/mo /etc. <br /> Heat um Backflow reventer inside bld <br /> Unit heater Urinat <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> Ducting Roof drains <br /> Other___ Medir,al 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 urdinances governing this type of work will be comp <br /> with whether specfied herein or not.The granting of a permit does not presume to give authonty to violate or cancel the provision of any other state or local law regulating construction <br /> That I am authonzed by the owner of Ihis property to perform the work for which application is made and I comply with the State Cortrectors Law 1827 RCW and 296200A WAC. <br /> n <br /> 'Vl�ll�_� U f �C.d.(~� <br /> Owner/Authorized Agent Signature Date (Revised 4l2015) <br />