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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 4t PERMIT# <br /> -=`�'i� �t,��i�k� ��'�- � �a c�� '7 i ;� �-1 c: ( 2� c' G - <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER �I�14i�7 �� ���2�Tt" �cc `t--tS�-� K�1� T one/E-ail <br /> Address ��2, �i i�r� �L- �/1 j� (�L, �1 ' City/State/Zip � �`{ Y����' `S�.r�/V�J j �,�� 1��'`� Z <br /> APPLICANT:_Owner _Owner'S Agent COf1tf8CtOf _COfltfaCYOf S AgBflt _T2f12f1t(must provide a letter ot consent from the owner to do work in ihe space) <br /> CONTRACTOR ;Z�. �' ��oca /a rv ' cT' State Lic.# F;1 1-4 c'�'�X�j f:�����. City Bus. Lic.# t.>?c�5 I rj <br /> I;IC`c> ��ZTf� A�fC S ; `.�C.-_/1lTL-�z��/a �1� IC v L��t 7L�•c�:�t�C.� <br /> Address Phone/Email �.,$���;�2�D� ' 'r"thCU� �CG�� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �;c:vit�s�1 £1T� j���� r'i.���--�ti� �5��l� Jay 5�t-+rvF�'�Y ���.,�z4� , c�i4 G <br /> Phone/E-mail � •S�6�i���,�0� C.,�"fi�1 C�+�o �c�`'� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK `� Z.:r �C(��`' <br /> Existing Use of Building ��i 1 " ��i—�(.� �v .v HEAT SOURCE: <br /> Proposed Use of Building ��V�,( Gas Eiectric 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(additiona/space provided on the back): �Nc,TA��-'�' ��l"}-� <br /> s -`»l � � 'f{���,� <br /> �f�'� � ��� r� � � �-M. , <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 handlin units I Toilet <br /> � Forced air s stems I Bathtub <br /> I Gas i in Lavator (wash basin <br /> i Water heater i Shower <br /> � Gas fire lace I Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Clothes dr er I Clothes washer <br /> � Ran e hood Water heater <br /> i Exhaust fan Sink service/bar/mo /etc.) <br /> ( Heat um Backflow reventer inside bld <br /> Unit heater Urinal <br /> � Boiler Drinkin Fountain <br /> j Refri eration Floor drain <br /> I Woodstove � Grease tra <br /> I Ductin I Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I 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 comp <br /> with whether specfied 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 m authorized�he owner of this pro�erty to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br /> �i � <br /> � �� � q � ZC,.-; l � J,� _ <br /> OwnerlAutho ed Agent Signature at (Revised 4/2015) \ <br /> I� <br /> ,�,�....", <br />