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• • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 320Q Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS' PROP RTY TAX# P RMIT# � <br /> -y �� � � �-�- c s� `7a��o��UU ' ���l��s <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER _��i,5� f �C '� Phone/E-mail <br /> n, � <br /> Address /����p �� �'- j�`� City/State/Zip �'��'J�� �^f�, J+j��� <br /> APPLICANT:_Owner _Owner's Agent �Contractor _Contractor�S ACJ2f11 _T8f78f1t(must pro�itle a lelter of consent from the owner to do work in lhe space) <br /> J <br /> CONTRACTOR .i�� � � �i./ ( �� (,�j r "' State Lic.# City Bus. Lic.# <br /> 7���s ��� , �7� ` �, �s- . �-� 3�� <br /> Address �j' ��Uz �X � IY��IG'7Jl/.S � Phone/Email ��- �' '�/� ,SLc%Of2��� UG, C�Y1� <br /> TENANT BUSINESS NAME CONTACT FOR P�Ef,2MIT <br /> L f'/�f �?���Y S [.��"R'7'—� <br /> Phone/E-mail �e���.�*��/—��7 / <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building ���� HEAT SOURCE: <br /> Proposed Use of Bu�ilding S��� Gas Electric � Other <br /> Building type: G'"�Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> T pe of pro'ect: New Addition'.� Remodel Repair T.I. Si n S rinkler Demolition Chan e of Use <br /> DE$.C�RIP�JO/V OF 1NORK(add�'onal space provided on t�back): '� `� ` <br /> ;J Cl� ��! c�' " �'/( ' ��fSFc���oi�l �`� nS��� Cz'(�'t'�� �e/I{. C�!_'��J� . r E''�-i' ;cqrY /a''rr:z1.� <br /> � ,�����i�2Qe��) �1 l�'1�- C. <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New�Addn _Alteration_Repair Type of Project: _New_Addn �Alteration_Repair <br /> Show Num6er(# of fixtures Show Number # of fixtures <br /> A/C—air handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas pi 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/mo /etc. <br /> Heat pump 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 thal I have read and examined this application and know the same to be true and correcL 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 violale or cancel the provision of any other state or local law regulating construction <br /> That I am authorized ti'y the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> .r`r � ' � <br /> �` ��- �;��;��i�,���c,�--�l ` / <br /> Owner/Authorized Agent Signature Date (Revised 4/2015) L/� <br /> l � <br />