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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 ADDRESS: PROPERTY TAX# PERMIT* ` <br /> CJ1K- F _� L1014 ( -66Z/ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER .off-M. ... C� ,. ,c a 12 f)9-t` Phone/E-mail 21j - j 7, /" z..C�/� <br /> Address 9y. 3 Gjq=- ��-/ti_e /V IF . City/State/Zip / f $ ti E.-- �L��j /��'- 70 <br /> APPLICANT: /OO/wner _Owner's Agent _Contractor _Contractor's Agent Tenant(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR t-1.--- State Lic.# City Bus. Lic.# <br /> Address .5,441.6- Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK -- <br /> Existing Use of Building j1/-€',4/ ?...5F744',7',"/ Z15 _ HEAT SOURCE: <br /> Proposed Use of Building 5/104,90_ ( Sha- 1 Gas Electric Other <br /> Building type: J Single Family Duplex Townhouse Mul Family Commercial <br /> Type of project: New Addition Remodel _Repair ' T.I. Sign Sprinkler Demolition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back):STa Ic .,1,,,,V,--e a yype�r�/7-,-7- 2) -j-Le ' <br /> hi-il2) ?.�.E S'/G✓—1 T.E. _e' S�,r✓ � _ /c9 c e,,,,,/,A.4.,,,..: ,R��".s d 3- 57ot-:4.�, <br /> 4‘.1„7,1.1 f— ie/.4ie/.4T/if s f►sl e_,Li/4 � JI/f 1+/ /�.t j+ 5" -,4", %y� <br /> IQ G - 2-60`,'a 1 OZ,... 1 , 4 lv/14 c, l a 6,010 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: __New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration i'Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C-air handling units . Toilet <br /> Forced air systems ; Bathtub <br /> Gas piping j Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace J /---41.itcber4sicik&disposal <br /> Gas rangeIsh"6�her� <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan J Sink(service/bar/mop/etc.) if <br /> __ <br /> Heat pump Backflow preventer 7 . __] 9 <br /> Unit heater i Urinal �" <br /> Boiler J Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove J Grease trap <br /> Ducting J Roof drains <br /> Other Medical Gas <br /> — <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 complied <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 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 /> Owner/Authorized Agent Signat/0.- Date (Revised 3/2013) <br />