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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.evereftwa.org <br /> SITE ADDRESS: PROPERTY TAX a PERMIT# <br /> C. 'Sstt 30 12x". ,1)114-0g 6 6 c <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER 1:7'0%.S1./~'V► Phone/E-mail 4-25—"<..)1. <br /> Address '' c5ca'5 J. CJ' 1.1 ta-o. City/State/zip ev eg.t 1 r- \..t a `t B 2:03 <br /> APPLICANT: Owner „] Owners Agent _Contractor Contractor's Agent Tenant(mual provide a latter of consent from Boot tod+work in Co space) <br /> CONTRACTOR r pat. State I.Ic.#1)oF• MGG 1,4A-14G City Bus„l.Ic,# <br /> Address '',04.3.2s \ . C.AsrtNJ© v.-a Phone/Email 17.13(+ <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> 3 t til t-4,e,'R1pE1"Zz.r31,3 <br /> Phone/E-mail 4.2-5'S -2$8`J� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building t'E. `z't° HEAT SOURCE: <br /> Proposed Use of Building *-ill, Gas Electric Other <br /> Building type: Single Family Duplex_Townhouse Multi-Family _Commercial <br /> T pe of prosect New Addition _Remodel Re Bair T.I. Sin Sprinkler •emoiition_ Chan of Use <br /> DESCRIPTION OF WORK(additional space provided on the beck); <br /> /T vs t..- CAC C t.S'x-t sJC, t t Lao C,, 4' <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 /> I AJC—air handling units I Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Kitchen sink&dis.osal <br /> Dishwasher <br /> lot es dryer Clothes washer <br /> Range hood" <br /> m_S kse <br /> $aterheater <br /> Exhaust fan rvice/badmoptetc.) <br /> I Heat purrs, Backflow e.reventer <br /> Unit heater Urinal <br /> Boiler brinks Fountain <br /> Refrigeration Floor drain <br /> I <br /> ,tee ,a _.... ... .. . <br /> Woodstove r• : �` <br /> Grease trap <br /> I : DuctinB oaf drains <br /> Other Medical Gas <br /> PR ° R I 'UPPRESSION SYSTEM Other: <br /> Number of Heads I 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 lawn and ordinances governing this type of work will be complied <br /> with whether specified herein or not.The granting of a permit does net presume to give authority to violate or cancel the provision of any other stale or local law regulating construction <br /> That I am authorized by the owner of this property to perform the work for which application is made and I comply watt Me State Contractors Law 10:27 RCW and 296 200A WAC. <br /> j ✓ ri <br /> Owner/Authorized Agent Signature Date (Revised 3/2013) <br />