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� <br /> � � <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.everettwa.org <br /> SITE ADDRE S: � , PROPERTY TAX# PERMIT t# <br /> /G'C�/ %l ���- ���c� � ��c'��'_� -,Z�L�S%7�'�'� � ��'�% � � � <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> j'' � �p� /� �7 � // <br /> OWNER L ���'f'// ��:L�ill�lCAf� �c���f I� �f U. �UEG �' hone/E-mail yf��'�J�'���/f1 'i��L �' ll���/ ��CC���/�'✓ <br /> add�ess�UL'�> "v'6i''r �i�/"�'v c�riistateiz�p � /�/�-� �t�r4 � �:�-G, <br /> APPLICANT:_Owner �Owner's Agent _Contractor _Contractor�S Ag2f1t _T2f18f1t(must provide a letter ofconsentfrom the omnerto do work in the space) <br /> CONTRACTOR /J�'f State Lic.# City Bus. Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> ,�r✓,�. �I l��� YL-�, �'���� ���<l�/f=<�, l.,c. <br /> � � Pno�eiE-ma�i — /•3,��'G' C� �'��'j���l�Cr/�����y�., ,iy� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK��L�i�c'G=(�S�%�<tiY`"�/; <br /> Existing Use of Building �' '.t'�� C LZ<` t' � � �`v�✓�,!f �tL HEAT SOURCE: <br /> Proposed Use of Building�/-} Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family �Commercial <br /> T e of ro ect: New Addition Remodel Re air T.I. Si n S rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): <br /> �E'/�'c: �i���2���2,� �.�lSli�2� �c�u/l��l� l�t<�r<� �Z�'�li� �� F S��t� Ir�,�; <br /> r�. f t�-k�=������ �.4�t, <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 fiutures <br /> A/C—air handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas i in Lavator (wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Clothes dr er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink(service/bar/mopletc.) <br /> Heat um Backflow reventer inside bld <br /> Unit heater Urinal <br /> Boiler Drinkin 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 specifed herein or noL 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 for which application is made and I comply with the State Conlractors Law 1827 RCW and 296200A WAG � -�_� <br /> i <br /> 1 ' ,'� � _ � �� ����� ��Z_� <br /> Owner/ orized ge Signature Date (Revised 4/2015) <br />