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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 /> �f�,, ®`, APP�LIjCATIONNS ARE ACCEPTED FRROM 8 AM TO 44�PM <br /> SITE 1'357— r7 V� �v1exe- W 1 `15261 Itw P��CJ6.)t MIT S- 02,3 <br /> LEGAL -chM, <br /> for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER T�1"11 cL EJ(''( Phone/E-mail �"�{�,,p 3 U <br /> Address \? 2 Cl nO, \f� City/State/Zip e\ QW`J-T <br /> T' ckSa0i\ <br /> APPLICANT:_Owner _Owner's Agent +;/\Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to e spac <br /> CONTRACTOR eme tta.. N*al, / L&I Lic.#( ►�-t;.eN ft 2ZCOE Bu Lia# 39 <br /> �� <br /> Address 8a5 s 0 E t saiwww,Nct, t3L4 Phone/Email ' ) 1_,j- ' S <br /> TENANT BUSINESS NAME C NTACT FOR PE IT �I�ra)au�Q) <br /> &("r Cin \ ,'�'','_I` , <br /> Phone/E-mail\.a— j Q IQ c hQX <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 0 <br /> Existing Use of Building_ _ HEAT SOURCE: <br /> Proposed Use of Building_ Gas i( ElectricX Other_ <br /> Building type: Single Family Duplex_Townhouse Multi-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): <br /> MOLAR k\\true, Tesial Ate- <br /> G,1c)-'v e, • t H k&C C6M C v�.VB jCYS BTU i vane- 4TfV ,6 <br /> 1 <br /> MECHANICAL PERMIT APPLICATION PLUMB( G PERMIT APPLICATION <br /> Type of Project:KNew_Addn _Alteration_Repair Type of Project: _New_Addn Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> k Water heater Shower <br /> Gas firepFtlt 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 Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <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 authorize 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/,(horized Agent Signature Date (Revised 6/2012) <br />