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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.evereitwa.org <br /> SITE ADDRESS: PROPERTY TAX il RMIT <br /> ��' �!,y _ `� ) <br /> 1�c'k� -�. <br /> LEGAL for new construction: Short PlaUsubdivisiontZ'�'�+� � - \'ra'Z.k- Lot No. . (attach copy of long legal description) <br /> OWNER���.t+4�LIC_ �6�.C.�1,��-t-- � Il.�:�i/i t�5 Phone/E-mail ��Z.`'a� ��� � - z``C��' <br /> ii'Z-C: �t`c..a��2t"z-t i W�'L� �.v�-�—'� .., r- �.� <br /> Address �''v � << �`c�; City/State/Zip �.'��G`4 L �� U:.•L�4 _ ��4;,c� �_�� <br /> APPLICANT:_Owner _Owner's Agent _Contractor _Contractor�S A98fll _T8t18f11(must provide a letter of consent from the owner to do work in the space) <br /> CONTRACTOR�-�Ez'��T�-�Z- �t��-l'.-�L ���v�S State Lic.�''zA���'�'����-� City Bus. Lia #I�C'�� 'ZL1(? '�(•'`� <br /> Address Cy,}�"�/1oL�_ Phone/Email ``j-i-\ y�,y 4 � <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas `�'j Electric 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 /> �C�S� �. <br /> , --- , • - <br /> _ <br /> '� L �l 7 � � 't �-y� r',`l-y.''�� �-`'`-' t �•"- _. �ty,-� _ -"� _� �b ��-[t.'�- <br /> 1�3 t!S.�.. ` � - � �� -�� <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 �3 � Toilet <br /> � � Forced air systems Z � Bathtub <br /> j Gas piping Qj j 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 -t - eater <br /> - j Exhaust fan 1 Sink(service/bar/mop/etc.) <br /> ,>-- j Heat pump .--. Backflow preventer <br /> -- ; Unit heater Urinal <br /> d--- Boiler -, i 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 lo be true and correct.All provisions of laws and ordinances governing this type of work will be complied <br /> with whether sp cified herein n he 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 autho zed y the n f this property to pertorm the work for which applica[ion is made and I comply with the State Contractors Law 18.27 RC W and 296.200A WAC. <br /> i i <br /> ,� � � <br /> �;J� ;,,��, _; - � `i- 1 <br /> Owner/A�{thorized Agent Signature Date (Revised 3/2013) <br />