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�� <br />LJ <br />� <br />PERMIT APPLICATI�N <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPI�INKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />TE ADDRESS: PROPERTY TAX # P�2 j I� L�✓�� <br />�-1��� ��m �+ G�Er2Er-r �qoy�t.,�c�un�oon U U <br />for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER <br />PhonelE-mail . <br />City/State/Zip <br />PLICANT: _ Owner 1� Owner's Agent _ Contractor _ Contractor�S AgBfli _ T8118�t (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR <br />BUILDING PERMIT APPLICATION <br />L& I Lic. # COE Bus. Lic. # <br />PhonelEmail <br />� rcn�n�� marlene 1,� �-�h�ers <br />�! a6 3a g a b �S y <br />PRICE OF' WORK <br />Existing Use of Building S F'R � HEAT SOURCE: <br />Proposed Use of Building S F 2 Gas_ Electric i� Other <br />Building type: X Single Family _ Duplex _Townhouse _ Muiti-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provrded on the back) : i(1 E� `W r1St1r'�/ <_t t O v� <br />�f 2w �t��Se <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fr�rtures <br />A/C — air handling units <br />Forced air systems <br />! Gas piping <br />1 � Water heater <br />SP <br />c�as range <br />Clothes dry� <br />Range hooc <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeratio <br />Woodstove <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fiactures <br />Shower <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />n <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be true and conect. 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 />That I am authorized by 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 />�C� <br />,r.r, o.,.�. �,�.,. 6 - 2 � —1 � <br />OwnerlAuthorized Agent Signature Date (Revised 6/2012) <br />