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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 <br />LEGAL for new construction: Short PlpUsubdivision Lot No, (attach copy of long legal description) <br />OWNER Vq1e1,.)Ce J,7c Q ee-K' (J % -e <br />Phone/E-mail 32 3 ^ 77D ^ O,,) S' a <br />Address L f1 <br />City/State/Zip <br />APPLICANT: Owner _ Owner's Agent Contractor — Contractor's Agent _ Tenant (mist provide a letter or consent from the ovmer to do work in the space) <br />CONTRACTOR �7Sfr-r,S <br />I State Lic. # CI i FS / City Bus. Lic. #5 <br />Address j�%ti SW0/rl PO/T a 97z1 7 <br />Pad- <br />- j' ;Zr J - 0 J 40 7 <br />Phone/EmaiIR�J 1hQQdY4tC F IJ/ (! Coal <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />f& v ►ry) y./s <br />Phone/E-mail -;z& r -0'1-& <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK jil U BOO <br />Existing Use of Building /*tipSAr'� HEAT SOURCE: <br />Proposed Use of Building �� �i �l S41 ev S 1 Gas Electnc Other <br />Building type: Single Family _ Duplex _Townhouse _ Multi -Family Commercial <br />Type of project: New Addition Remodel Repair T.I. Sin Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />_fit.)J cr/l 0 -yL() TA -. Ad -/ paw4o/ <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New <br />Show <br />ZAddn _Alteration _Repair <br />Number # of fixtures <br />Type of Project: <br />Show <br />_New _Addn _Alteration _Repair <br />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 />Ran e 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 />Drinkin Fountain <br />Refri eration <br />Floor drain <br />Wood'tove <br />Grease trap <br />Ducting <br />Roof drains <br />Other e-) -k)-d el ouev <br />Medical Gas <br />SPRINKLER <br />/ SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby certrfy that read and amined is application and know the same to be Wa and correct. All provisions of laws and ordinances governing this type of work will be wmpi <br />with whether sp l herein or The gr ti 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 au ri by the oif'his eery to perform the work For which application is made and I comply with the State Contractors Law 18.27 RCW and 298.200A WAC. <br />r/A <br />lure <br />3 - / � -ls-- <br />Date <br />(Revised 912014) <br />