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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRIiVKLER/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# P MIT# Q( <br /> (��� �-L'LKC.�E=L.L-�'7� l�Y� . � ( � <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> (C7{� / ��^- <br /> OWNER �� �("j� ��{��`'(`("' Phone/E-mail�Q�j��2�'�'.'��J[ m�G�'��• �TSY(G v' �.' <br /> Address f�j2.( ��.�JY gY�. CitylState/Zip �.Y�-���, �f�• �8 2�� or`� <br /> APPLICANT:_Owner �,Owner's Agent _Contractor _ContractoPS Ag@flf _T0f18�f(musl provide a letle�of consent from the owner to do work in the space) <br /> CONTRACTOR ������'� ���5��1 State Lic.# City Bus. Lic.# �i�T�J � <br /> 1a23 hlE �'�lt�S'('2 t�SZ(�!� r 57�. 3�4 <br /> Address K(p/u'�r�6X'7,V�ls�. �Q�b�j7j Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT -�--,EYj� ��YL�j� <br /> ��c tz�o-�Gc-. rvcE�cc,�t� G-��p (�?.�,� 25°1 •o S�a <br /> Phone/E-mail ��� ��ha�-�fi •�m <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK -� �b�Dl�Y.dD <br /> Existing Use of Building_�/C�'�lC�l G(.(t�(,(G ' ,"�J� OCI.l • HEAT SOURCE: <br /> Proposed Use of Building �.�G,�SC(� GL.(�.((C `��J dl-G• Gas Electric Other_ <br /> Building type: _Sinyle Fa�nily _Duple;<_�ownhouse _Iviulti-1=amily _Coii�mcrcial <br /> Ty�e of project: iJew _Addition Remodel . .Repair___T�I. _ ._Sign __Sprini<ler�DemolitionT___Chanqe of Use <br /> DESCRIPTION OF WORK(additional space p�ovided on the back): <br /> (t-f(���b't� t7E�.�a(�ttTd�--� � E?�tllClti-(G� `t��+�L-S, G�L«14, �(�ll�, `� <br /> � SG(L-CT�t vC tX-Ts�b(.1`f'1D�i � �te�F=�-ff��l�'.Art� -t- E=(-.�'�(C.�(.� <br /> ��'�✓`� . S�G�E-1�7 �Ldd[z <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 fxtures Show Number(#)of fxtures <br /> A/C—air handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas i in Lavato wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ran e � Dishwasher <br /> Clothes d er Clothes washer <br /> � Ran e hood Water heater <br /> Exhaust fan Sink service/bar/mo /etc. <br /> Heat um � Backflow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> � Woodstove Grease tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: <br /> Number of Heads Other: <br /> I hereby cerlify that I have read and examined this application and know the same�o be We and wrrect.All provisions of laws and ordinances governing lhis type of work will be compl <br /> with whether specified herein or noL The granting of a permil does not presume to give aulhonty to violate or cancel the provision of any other state or local law regulating construction <br /> That I am authorized by the o ne of this prope to perform the work for which application is made and I comply wilh the State Conlractors Law 18.27 RCW and 296.200A WAC. `� <br /> % ' <br /> — � . <br /> � /L • r= . �� /� <br /> �J ✓ <br /> OwnerlAuthorized Agent Si re Date (Revised 9/2014) <br />