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� • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 wwr,v.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: ���� � 1 t �• �� PROPERTY TAX# P T — � <br /> �u� <br /> LEGAL for new consVuction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER ' � Phone/E-mail <br /> Address � � � 1,.�5 City/State2ip � ���.-�� � W �u 2 U <br /> APPLICANT:_Owner _Owner's Agent �Contrador _ConVactors Agent _Tenant�m�st pro��ae a�enerormnsenc rrom me own�r ro do�.o�c e spacz) <br /> CONTRACTOR � � \ 1VLC • L&I Lic.# ��� �l9 4 r�� COE Bus. Li .#�•632c�� ( <br /> Addr2ss �V� ��� � Y1QQ..�LY�, G + �v 1�\���Q�� `11��� Phone/Email �l�S � \ 0��� � �✓ e,-' <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT ' <br /> �Se.r�n e � � <br /> Phone/E-mail SQ�`� (l C}� ��C.��Q �l ' � � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF W K Z �`�(o . <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Us2 of Building Ele Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family �Commerciai <br /> Type of project: _New Addition Remodel Rapair_T.I. Si n_Sprinkler_Demolition Chan e of Use <br /> DESCRIPTION OF WORK(additiona/space provrded on the bactc): ., <br /> -Q.�� � ls�v�,�� os���`�o�, �r�o.�i ��.��v� �.x� �o�r^-� �S��i o�n r ��fi-� r� , <br /> �` ��\CR �o f .��\�- . , � <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 fxtures Show Number(#)of fixtures <br /> ! A/C—air handling units I Toilet <br /> I Forced air systems I Bathtub <br /> ; Gas piping j Lavatory(wash basin) <br /> � �Vater heater ! Shower <br /> I Gas fireplace I Kitchen sink&disposal <br /> ; Gas range j Dishwasher <br /> Clothes dry2r ; Clothes washer <br /> ; Range hocd ; V�later heat2r <br /> j Exhaust fan I Sink(service/bar/mop/etc.) <br /> Heat pump I Backflow preventer <br /> ; Unit heater � Urinal <br /> ! B�i�2� I Drinking Fountain <br /> Refri eration ':, Fioor drain <br /> , j Woodstove i Grease trap <br /> Ducting Roof drains <br /> j Otner ; tiledical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM ! Other: <br /> Number of H2ads Other: <br /> i n�r=jy ceClf�1�a!I ha�r:r=3d and�eaminar�Ihis applir7t�on and kno�.v Iha same to be Itue and correct.A.I prnvisions of laws and er7inancas y^ov=_ming this type of wor?c w�ll be complied <br /> ;n!n:ne:��r;pac;r,�d hare!n or r.ot.T`i�gr3nhng of a pennit does not pr�sum�!o giv�au:herty tn vielat�or cancal the provision of any oth�r stat>or local law re,ulating constn�c!ion <br /> i'iat I am authorzeA by th�o�.vnar nf this propery to per`orrn tha work for which apolicahon is mada and I compty with tha State Contractors Law 13.27 RC`�'!and 297 20QA 4Y.�C <br /> c__.�-- ��( . �.�( � � � <br /> ner! utharized Ag Si n D�'� �?���f���20�z�1� 'I � <br /> �/ <br />