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PERMIT APP A N <br /> BUILDING/MECHANICAL/PLUMBIN /SIG /SPRINKLE /DEMOLITION <br /> CITY OF EVERETT P RMIT S VICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-881 FAX 425- -8 www.everettwa.org <br /> SITEADDRESS: PROPERTYTAX# E T � <br /> �ra � h�.af�f�-�� l�l�EvJ Df�.. r- <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER � � � „J — � Phone/E-mail � � "-�-- <br /> Address City/State/Zip Cj � � <br /> APPLICANT:_Owner _Owner's Agent �Contractor _Contractor's Agent Tena vide a letter of consent from the owner to do aea}, <br /> CONTRACTOR � C � �'A - � -T State ' .# �;C�,�,,�; }� City Bus. ic.# b?Z91�j � <br /> Address J <br /> 2,��(p �r�-t>t�.l� !�� � �-�7 � �TLS Ci �iaLJ r/� e/Email --�. -��"�- 9y� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> "�-�f�Zv1._1 Dt��'t�a <br /> �1/C.�� �.►�1�I f�.)�� �']tJ C_.� �`�3'?_.��,-7;:c;(� <br /> Phone/E-mail '� ,f r-� � � �t�5� f�� �,�nn <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � (¢�.��a <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas Eiectric Other <br /> Building type _Single Family _Duplex_Townhouse _Multi-Famiiy _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�►�� -rv.�� p�-y sy�r�;� �►��r-�s ,��..�� �N� �-�..� <;y3-r�r:... �'����.�c� ..���eT <br /> �},�L� g��� �.,,..�.���� �y �r i�. . <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteretion_Repair <br /> Show Number # of fixtures Show Number # of fixtures <br /> � A/C-air handlin units i Toilet <br /> � Forced air s stems Bathtub <br /> ' Gas i in � Lavato wash basin <br /> � Water heater Shower <br /> i Gas fire lace i Kitchen sink&dis osal <br /> I Gas ran e ! Dishwasher <br /> Clothes d er Clothes washer <br /> � Ran e hood Water heater <br /> Exhaust fan I Sink service/bar/mo /etc. <br /> i Heat um Backflow reventer <br /> i Unit heater Urinal <br /> i Boiler Drinkin Fountain <br /> i Refri eration Floor drain <br /> ' Woodstove i Grease tra <br /> Ductin ; Roof drains <br /> � I Other � Medical Gas <br /> SPRIN LER / SUPPRESSION SYSTEM Other: <br /> � � i <br /> Number of Heads I Other: <br /> I he y certify th I have rea and examined lhis application and know the same to be true and correct.AII provisions of laws and ordinances goveming this type of work will be comp <br /> with wh ecified here' 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 4tl owner of this property to perform the work for which application is made and I comply with the State Con actors Law 18.27 RCW and 296.200A WAC. <br /> .1"� � �� _. ._ <br /> l�Co �� � <br /> Owner/Authoriz gent Signature Date (Revised 9/2014) <br /> �� <br />