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� <br />� <br />PERMI�' A��LICAT9�N <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 />ITE ADDRESS: <br />�i�/� <br />LEGAL for new construction: Short PlaVsubd <br />OWNER KGi�.�(�, � C <br />Address `-7.�,�/ . <br />APPLICANT: Owner <br />TOR <br />'� <br />r��. k z,�r � <br />Owner's Agent � Contractor <br />BUILDING PERMIT APPLICATIOfN <br />PROPERTY TAX N <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail yZ' � � �� — � <br />City/State/Zip L�. C:�1�-1�j� L,�'�/� �fr � V� <br />COf7tf2CfOf�S Ag2�l _ TBfl2flf (musl provide a letter of consenl (rom Iha owner lo do work in the space) <br />State Lic. # �'' K��� .l L City Bus. Lic. # <br />C�' �� Phone/Email y )^ 3 �� ( <br />CONTACT FOR PERMIT <br />�./ /,(y // %� <br />Phone/E-mail /J� �� Jo "r'� % � " � � <br />CONTRACT PRICE OF WORK <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: � Single Family _ Duplex _Townhouse _ <br />Type of projec! _ New _ Addltion �Remodel _ Repair <br />QESC RIPTION OF WORK (additiona! space provided on the back) : <br />� �' - l�D C� I <br />MECHANICAL PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />� Forced air systems <br />� Gas piping <br />� Water heater <br />� Gas fireplace <br />� Gas range <br />� Clothes dryer <br />� Range hood <br />—� Exhaust fan <br />Heat pump <br />� Unit heater <br />I Boiler <br />� Woodstove <br />� Ducting <br />� Other <br />SPRINKLER / SUPPRESS18f�1 Sl(�i�iVi <br />� Number of Heads <br />G <br />Multi-Family _ Commercial <br />T.I. Siqn Sprinl<ler <br />HEAT SOURCE: <br />tion Change of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Sitow Number (#J of fixtures <br />� Toilet <br />� Bathtub <br />I Lavatorv (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/e <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I nereby ceriify 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 h rein or not. The ranting of a permit does not presume to give authority to violate or cancel lhe provision of any other slate or local law regulaling construction <br />That I am authorized the owner o( t s property to periorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br />:���� <br />� �� � �/ ' <br />/ �` � Q /C-- <br />U _� <br />Owner/Authorized Ag n ignature Date (Revised 3/2013) <br />