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� <br /> ERMIT APPLICATIO I <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICE:3 <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810 — FAX 425-257-F3857 —www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 F'M <br /> SITE ADDRESS: PROPERTY TAX# ER T# <br /> ��.���� �-Z � }�j,�1� _S-� `� �, t.�� �f��� �='��'�C�'(-3 � �j r" _ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER n-� �,, �,/�� /� L />1C,t�yK.: . ��!-.Sl��C.� %, ' t��'1C.'�-c - C�i'�� <br /> 1 /"��1.�+'�"�l.��J Phone/E-mail :sJ . � J .22.C%� <br /> Address �ZCi IS ��'1.�- b1 �(.%� � Sfi -� City/State/Zip �-��� �,((jv, ���} �j�j��3 <br /> CONTRACTOR �,/1nCL� �^L�C��L�'IL�a.�Q/,��' L&I Lic.# '� �ri.��4N'= 3 `C.-�' <br /> Address �Z�j�S C.L-(,,'li.1,�1 �C-�� C ,5�� � 1"(,��; �I�,l,''' ��G'_�� Phone/Email �S����� �<,�i� <br /> TENANT BUSINESS NAME � CONTACT FOR PERMIT ry�-��� ��1� Sh C%/�S� <br /> `�'��� Phone/E-mail ��j .:S���3 �C,i�(�� <br /> � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building �'II� -�);��'tLL,� ��.'1��2�-tC��["7�'1 HEAT SOURCE: <br /> Proposed Use of Building Sr�. % I�'m,r�nrx.�� m cacl�..t Gas Electric Other <br /> Building type: �Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: �New _Addition k Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> � <br /> Description of Work(additional space provided on the back): ���)��'(��) <br /> (�.,1f1�°�1.� �CIE.�Cl� tZ.� SC-�-�.,r2'� C��ui- L��;�I� b� C C�/1�,�.i�'C:L �C�. L+�h�,/1 <br /> �IGt,t i S c�-(;�S-� 12� �C�l G�.L� � <br /> Have you started working without a permit? YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBINCi PERMIT APPLICATION <br /> Type of Project: _New_Addn l�Alteration_Repair Type of Project: _New__Addn �C Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C-air handling units } Toilet <br /> j� Forced air systems (,,a Bathtub <br /> Gas piping '�` Lavatory(wash basin) <br /> �, Water heater Shower <br /> L Gas fireplace ') Kitchen sink&disposal <br /> �� Gas range Dishwasher <br /> L� Clothes dryer �` Clothes washer <br /> �'� Range hood ' ) Water heater <br /> Lg Exhaust fan %' Sink(service/bar/mop/etc.) <br /> (,> Heat pump � Backflow preventer <br /> Unit heater Urinal <br /> i Boiler Drinking Fountain <br /> Refrigeration U ' Floor drain <br /> �� Woodstove (J Grease trap <br /> �) Ducting j Roof drains <br /> � Other (� Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM L� Other: <br /> � <br /> Number of Heads � ��ther: <br /> I hereby certify that I have read and exarnined this application and know the same to be true and correct.All provisions of laws and ordinances governing <br /> this type of work will be co ed with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel <br /> the provision of any other ate local law regulating construction or the performance of construction.That I ain authorized by the owner of this property <br /> to perform the w pl ation is made and I comply with the State Contractors Law 1827 RCW and 296.200 WAC <br /> ,�. <br /> ' S%�t I Z <br /> Owner Age t-Sig e Date (Revised 2/2011) <br /> 'l� <br />