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• <br /> PERMIT APPLQCC T O <br /> UILDI G/I IEC I iNICAL/PLUMBING/SIGN/SPRINKLEI /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 1tR <br /> PfE MIT# <br /> . .. l/- � . r-. —_ . �. t%'l <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of Ong legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> APPLICANT: Owner _Owner's Agent _ Contractor Contractor's Agent Tenant(must provide a letter of consent from the owner to rip work In the space) <br /> CONTRACTOR Xy i117cCH'A.vs'.[4./ l., State Lic.#/CE C:W .2 VD/✓ City Bus. Lie.# C13a3-7 7 • <br /> _ 2c - 72-7g <br /> Address/7V!0 'yH . S K44/2— <br /> '4/% LJ.4 990'e: Phone/Email Lie-awe Ltt:)ke)'<//C.0//1/.r/1e/IZr e.e <br /> • 1 : 1 ' ' • r CONTACT FOR PERMIT <br /> -o6-J9 - ,SO2 <br /> .. ;-/, <br /> 771 E yE1Q Phone/E-mail C/7C'oA/VE L e rt y,,,PCi,,Aar2.C%C . C&,"Jy <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK I7S. c:" :' <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas__ Electric Other <br /> Building type: —Single Family _Duplex Townhouse _Multi-Family ,, __. Commercial <br /> Type of project: New Addition _Remodel Repair T.I. Sign Sprinkler Demclition Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): Er L Ale-` €x l,yT',✓ - ,... kA is✓.✓ `c'AG.S <br /> 1 G /E <br /> ,/.V 4J C.41 1Ouil/'iC zv . `-ii V 4' rkFC/ 3 .?/gf W Cr ECL <br /> a4,4e/vS“As 2 2 HMA k /1111 COWS. <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 /> NC—air handling units Toilet <br /> Forced air systems Bathtub <br /> T Gas piping 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 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 /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> • <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 /> Tha m author' y 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 /> "ner/Authorized Agent Signature Date (Revised 4/2015) <br /> 1 12 <br />