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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.everettwa.org <br />.'� ► i ��"`I ��� )I <br />ADDRESS: <br />for new construction: Short PlaUsubdivision <br />TAX # <br /># <br />Lot No. (attach copy of long legal description) <br />l: �1 Yl C'�-S� <br />Phone/E-mail L� '1 G-� �� L.1G "1 I J17 �.... _ `_ . .,.� . <br />CG,h <br />(� Owner <br />�f1.fZ�'" <br />City/State/Zip <br />Owner�S A9@IlY _ COf1Yf8CY0f _ COtltfBCtOf�S Ag@Ilt _ Te�aflt (must provide a letter of consent from the owner to do work in the space) <br />� <br />BUILDING PERMIT APPLICATION <br />State Lic. # <br />Bus. Lic. <br />� IPhone/Email <br />ACT FOR PERMIT ��V`� vr P.q�Zt��c� <br />�l r� �'' �J i r1 hC�lP�J2 ^Q�2C� t=. C,�%ti+J� <br />PRICE OF WORK �tn� <br />Existing Use of Building �f�r�` �� ,A�C> HEAT SOURCE: <br />Proposed Use of Building K.rz_�i c�-��o Gas Electric� Other_ <br />Building type: x Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project New x, Addition Remodel Repair T.I. Si n Sprinkler Demolition Chan e of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />iiC'�.C��"�1 ���- �� � r-.�' °�.t..�' � Ckl�vu�w�� t'Qc'� �N� C`�.�n ��`� c�c'� t.� <br />V <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Num6er (#) of fixfures <br />A/C — air handlin units <br />Forced air s stems <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes d er <br />Ran e hood <br />•�__ Exhaustfan <br />Heat um <br />Unit heater <br />Boiler <br />Refri eration <br />Woodstove <br />Ductin <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />Bathtub <br />i <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.; <br />Backflow preventer (inside <br />Urinal <br />Drinking Fountain <br />Floor 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 laws and ordinances governing this type of work will be compl <br />with whether specifed 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 authorized by the owner o h property to perform the work for which plication ' made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. � <br />/ � '_ � 1/ <br />/ e�/ r� <br />er/Authorized Agent Signat ate '� (Revised 4/2015) <br />