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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 /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX# PERMIT.# <br /> zl Z7 LV5-rNvo .6 AV • c�¢39/g36Di¢ct� C l; -©1 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. /.3 (attach copy of long legal description) <br /> OWNER t14446,T MbtA4J'0/V Phone/E-mail ZP�6 193—�9�° Alor J'G/ItJ�/ <br /> •CQ <br /> Address /0 y/ J-1 City/State/zip L V U44 - 9�?90_r- <br /> APPLICANT: ✓Owner Owner's Agent _Contractor Contractor's Agent _Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR 0 W M5AL IL&I Lic.# COE Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT (; <br /> Zc,W - 7 q 3 -1-9 z� <br /> Phone/E-mail JL4 V f,n t VAJ 'c r C6 67 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK- G� <br /> Existing Use of Building hEAT SOURCE: <br /> Proposed Use of Building S' Gas V'—Electric_ Other_ <br /> Building type: _v'-Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project _New %'-'Addition ✓Remodel _Repair_T.I._Sign_Sprinkler_Demolition✓Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): hemp -W <br /> /Z 6lev' l ►.od�/ ft-mM!lV6 SF and A44 Afr.,fil/ / S`0 It g�c' <br /> A.hD MW FW MASr{ Mlilli 59 Z SF 'rvA.*,- NSD #WA= 2,733 sr- <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 handling units Toilet <br /> / Forced airs stems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range / Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler I Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> l <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads 1 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 complied <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 of this property to perform the work forwhich application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> 7ne,IAthorized Agent Signature Date (Revised 6/2012)` <br /> L <br />