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� • <br />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 <br />PROPERTY TAX # <br />www.everettwa.org <br />EGAL for new construction: �Short PlaUsubdivision Lot No. (attach copy of Ibng legal description) <br />ER <br />CANT: _ Owner ^�Owner's Agent � Contractor <br />RACTOR (�e�—r� �WS'T; I�1.Gr, l. C,nl Y i, i. <br />SZ'S�i,J <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building <br />CitylState/Zip <br />��c o <br />�i ,� <br />: <br />. <br />Contractor�5 Ag211t _ T@fl2fll (must provide a letter of consent from the owner to d9 work In ihe space) <br />State Lic. <br />S�►SatS <br />ail��l'�ill- Cb <br />IT �L, v (� �15� <br />iac:l�:� 'J4 S- tS�G <br />Phone/E-mail i'>f,j\ �.� <br />CONTRACT PRICE OF WORK <br />;�ty sus. �.��. #�5 Y3C� ti <br />"t'-I.Z-E'l�rliiw' C��xl:�St n�i <br />-i�C�yk�-- <br />C�'�2 `l; ar� j� : G�' i�T <br />C7 <br />HEAT SOURCE: <br />Proposed Use of Building �S ) i�i(9-L(� '��L �/ I Gas� Electric_ Other <br />Building type: ,� Single Family _ Duplex,_,Townhouse _ Multi-Family ,T Commercial <br />Type of project: New X Addition �C Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (additiona! space provided on the back) : A�D Y�.���' l i,��% C��. 7't� L-?jC,` IST ►�v(� 1'y?�SrL%�— <br />��.o�M., tvL.:�.; �-a-��s�.����p�tc� �� i�>�v,�►�t�ac� ��,� � t,�ia� oot,� i R�p l� i c�cnd�w <br />i�S��,Q,�r�,r�r� w¢��y .fz�rnrnp���P,� K����.-�- �a�����r.�..� Hs;,���u'z��5^���dE-�����s qn�1J <br />Nc� I-�ry Gt L-���C�'c� ��17� - <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />—( Forced air systems <br />� vvaterneater <br />Gas fireplace <br />I Gas range <br />^� Clothes dryer <br />Range hood <br />Exhaust fan <br />� Heat pump <br />--� Unit heater <br />� Boiler <br />i Refrigeration <br />; Woodstove <br />' Ducting <br />Other <br />SPRINKLER / SUPPRESS <br />� Number of Heads <br />SYSTEM <br />of Project: _New _Addn _Alteration ^Repair <br />Show Number (#) of fixtures <br />Lavatory (wash basin <br />Shower <br />Kitchen sink & dispo� <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/moF <br />Backflow preventer (i <br />Urinal <br />Drinking Fountain <br />Flaor drain <br />Grease trap <br />Roof drains <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 correct. All provisions of Iaws 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 296200A WAC. <br />� � � <br />/Au e Agent S�gnature Date (Revised 4/2015) <br />� <br />�I� <br />