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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: <br />PROPERTY TAX # <br />°Zgc l®©0 1t�c'S'Zo® <br />2MITO <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER ���5�C1 ��� is <br />Phone/E-mail <br />Address?a 5oX -S-+0 1 • c> <br />City/State/Zip <v� TTuF— 1�! ICE t.t4 <br />APPLICANT:fr <br />—Owner _ Owner's -Agent Contractor —Contractor's Agent _Tenant (must proWde-a-letter of consent from the owner to do work In the -space)- <br />CONTRACTOR ��X F 11; �('�rG�Y�C/J ��c>!J <br />L & I Lic. # opi I d� 00 COE Bus. Lic. # <br />Addressf0 5 oyc 514 h W Phone/Email 3 (G o S1}I <br />TENANT BUSINESS NAME <br />3 v� t•1 c) <br />CONTACT FOR PERMIT <br />.3 &.o s--+I I 'i �5 <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building A6srF Usis✓J HEAT SOURCE: <br />Proposed Use of Building 1k6*1t/U,'Ac.'rU t2 Gas_ Electric_ Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi -Family X 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) : <br />�iJS-?sI�C. /Z}4'=��/Z�/Ji�l,�2s S/t/`�� %�LC�®t q7-E✓% j2dfCfC-''iiF� <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Type -of Project: _New _Addn _Alteration -_Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory wash basin <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink-(service/bar/mop/etc.) <br />Heat pump <br />Backflow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting. <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER <br />/ SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />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 o er of this property to perfo e w for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />ner/Authorized Agent Signature Date (Revised 612012) <br />NZ <br />Q <br />S <br />