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. <br /> � ���IY10� /y���0'1������ <br /> BUIL�IIVG/I!lIIEGHANICAL/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 /> w 14U��00� <br /> SITE ADDRESS: / � / /� PROPERTY TAX# P IT ..- -__-- - <br /> ��(O — Nt V� �ui� L'1�, "� ��� �� _ -_ " , <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> � . � � <br /> OWNER. /' � � Phone/E-mai� IL �i' S ,�( i� �� '. �'�� �� �--. � . <br /> � _(/� _ C �� � (�c— � �:J i.�� r"�/��{i-'� .� ��.���,. 1 <br /> J i <br /> Address � _ ��� C��[�[„ — � �� City/State/Zip ' <br /> APPLICANT:_Owner �,�W�2f'S AyOfif _Conff2ctOf _Cofltf2cfof'S Age�t _T2n8flt(musl provide a letter of consent trom the owner to do work in the space) <br /> CONTRACTOR r=,� State Lic.# City Bus. Lic.# <br /> Address Phone/Email ���lU - �t�51,UP �� �/'�o�1Y'0�`� •�o <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT �� �/G��f��/C/r <br /> Phone/E-mail ��j�j li Z— �� ' <br /> BUILDING PERMIT APPLICATIOIV CONTRACT PRICE OF WOR � <br /> Existing Use of Building �- �'�—c_-X HEAT SOURCE: <br /> Proposed Use of Building � �[.�L'� Gas_ Electric_ Other <br /> Building type: _Single Family _Duplex_Townhouse ulti-Family _Commercial <br /> Type of project _Naw _Addition _Remodel _Repair_ T.I._Sign_Sprinkler_Demolition Change of Use <br /> DESCRIPI lON OF VVORK(additional space provided on the back): <br /> �c'lLP ��G!�� x;'�Lc.-' ��c� �'E F'�c.-<�� u��N7C'c�.�.� f4�� G�►�!c.�d S � ('(�U <br /> � � <br /> r �.,t �,�, , (:�;�t C `�'i .�V,,'; ,(� 'r•:'i�� <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 fixtures <br /> A/C—air handling units i Toilet <br /> � Forced air systems � Bathtub <br /> � Gas piping � Lavatory(wash basin) <br /> � Water heater � Shower <br /> � Gas fireplace � Kitchen sink&disposal <br /> � Gas range � Dishwasher <br /> � Clothes dryer { Clothes washer <br /> � Range hood � Water heater <br /> —� Exhaust fan � Sink(service/bar/mop/etc.) <br /> Heat pump � Backflow preventer <br /> � Unit heater � Urinal <br /> � Boiler j Drinking Fountain <br /> � Refrigeration � Floor drain <br /> � Woodstove � Grease trap <br /> � Ducting � Roof drains <br /> I Other I Medical Gas <br /> SPRINKLER / SUPPI2��S18�1 Sl(SY�iifl I Other: <br /> INumber of Heads I Other: <br /> I nereby certify that I have read and examined this application and know the same lo be true and correct.All provisions of laws and ordinances goveming ihis 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 lhe provision of any other state or local law regulating construr.tion <br /> That I am authorized by(he owner o(this property to perform the work for which application is made and I comply with the State Contracrors Law 18.27 RCW and 296200A WAC. � /Z <br /> � <br /> ' z�� 2���`� <br /> Own /Authorized Agent Signature Date (Revised 3/2013) <br />