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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: <br />PROPERTY TAX # <br />PE MIT # <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER 6LVE W -EV, C— LL-C <br />Phone/E-mail <br />Address Zoo C(2eSj�--LW C00/21 4�-/O yo <br />City/State/Zip rAL4Si -rk -7 S I, <br />APPLICANT: —Owner — Owner's Agent -xContractor —Contractor's Agent _Tenant (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR /4 O(\ -CA� /2S <br />e Lic. # 0 F N/ City Bus. Lic. #0'5-34?- <br />Statu�2 <br />AddressgOZ^ r� `i�.(� 2© 11, SN0(�M(S H '[0 `1d <br />_� CL� Y`vf.ic"( <br />Phone/Email `Y' �� 2 2� Y `,.� �+�CO► <br />v <br />TENANT BUSINESS NAME At jt�— <br />�L� l� J ��71� �1 �(5� \C,PS <br />CONTACT FOR PERMIT (� ] CO M , <br />G3 _ <br />Phone/Ern � h��IJIJ j,. ,WAhb <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK-A1O 000 ` P` YS <br />Existing Use of Building U 110\ HEAT SOURCE: <br />Proposed Use of Building tA A tA GA) Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi -Family X Commercial <br />Type of project: New Addition Remodel Repair T.I. Sign S rinkler Demolition Change of Use <br />DESCRIPTION OF/WORK <br />7 (additional space provided o7 the back) : <br />00' X 30X Jq' STtFr=L t301Lb Vq, <br />T }2+K1n1� SPACE--, -tea 2EMAI LD6 --V-0 13C- Si�Rl�0IV- LC 6 <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number #) of fixtures <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number # of fixtures <br />A/C — air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory wash basin <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />! Heat pump <br />Backflow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />1 Number of Heads <br />Other: <br />+h 16-s0 ` <br />C_t-) M <br />I hereby c at I have read and e ' ed 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 w ther spe fled herein or a 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 authorize by e o er this pro rty to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAG <br />e <br />Owner/Authori ent Signature Date (Revised 9/2014) Z' <br />