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� � <br /> � 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.ev�arettwa.org <br /> SITE ADDRESS: PROPERTY TAX# P MIT# � <br /> �� �'�fe cS�r" .� OcZ O O � � ' ' �'�' <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal ciescription) <br /> OWNER �wa/�i.JG/ f' f ,L L G {� one/E-mail v-7773 s i� ,F.' w �... <br /> � c � <br /> Address fj � City/State/Zip �. ��' � <br /> APPLICANT:�Owner �Owner's Agent _Contractor _Contractor's Agent _Tenant�m�5c Pro��ae a iener or�or,5em rrom we owr,er co do work�n ine SPa�� <br /> CONTRACTOR (�.,,� �{,.,����y State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FO PERMIT ���K �� <br /> �G� �-G�i n�� 11 �Gr' <br /> Phone/E-mail G wys �C;r'S�V �a..��l g <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 3�0:��'o + <br /> Existing Use of Building �rB�iedSe�.l1�^.w-/M,r�n�.�1vT,�,.e HEAT SOURCE: <br /> Proposed Use of Building S�r.� e Gas Electric_ Other� <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family �c Commercial <br /> T e of ro'ect: New Addition Remodel Re air T.I. Si n S rinkier Demolition Chan e of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): St_G G 5 (�u• (.E'-�- ,per.�r�'�'o1✓�w�'r'g,s <br /> St�v���/i'a/ �r� /:�< S�f'�?�y� ,�}o�E v�o y�<.�rS< <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT API�LICATION <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 Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&disposal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink(service/bar/mo /etc. <br /> Heat um Backflow preventer inside bld <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> ' Ductin ' Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM 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 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 wner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.`<!7 RCW and 296200A WAC. <br /> .- � —/ f ( <br /> Owner/ thorize Ag i ature Date (Revised 4/2015) tiIZ <br /> � <br />