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t'ERMIT APPLiCATidll <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 /> SITE ADD PROPERTY TAX#1 PERMIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> • <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT:_Owner _Owner's Agent f. Contractor _Contractor's Agent _Tenant(must provide a letter of consent from the owner to dp work In the space) <br /> CONTRACTOR\f ' '� cmq'— State Lic.#1-'� RAS ,,'(? •City Bus. Lic.# <br /> Address 1�`L1Z 'L� N� 5'L vii-drvN St_ L t hone/Emalll-1r�C.t. S' `&L- 1451 voc\, 1 L <br /> TE NT BUSINESS NAME ! CONTACT FO PERMIT <br /> " C\ j C�. `C crC2 r I COc-t l� t 0 <br /> Phone/E-mai SPS C S V yrs,(--Ca t-(OTiY 1 ` CO tr 1\ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK L/,. 2e 'N c--Z) <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric Other <br /> t <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 /> > �. . Nle h, -rte . 3,1,/,cciv c. 1=- c�1-1-;.� IN'\-C.L Tc_- L,_<.,Lfr-tri <br /> C>Pr:ice Co u-o,-& c <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT <br /> 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 /> NC—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin). <br /> Water heater Shower <br /> I Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan I Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> I Woodstove Grease trap <br /> I Ducting I Roof drains <br /> I Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> • <br /> LI U Number of Heads Other: <br /> I hereby certify that I have r•=d 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•-rein o 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 authori 7- •y t'-'• er of this prop= o perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> / — r2:2- 15 <br /> Owner/Aut .rized Agent Signature Date (Revised 4/2015) <br /> 12– <br />