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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />EADDRESS: �'V�.C� ":/iuf� PROPERTYTAX# MIT# <br />_3 n z a.�,s �,� s; s� f�s z��� �1��� 3-�� <br />3AL for new construction: ShoR PlaVsubdivision Lot No. (attach copy of long legal description) <br />'NER L y'c �C E%/ /id �' S/ N E- Phone/E-mail �,/0%5 — j c: s•— / S <br />ress G' L C` �3 z r.� ac�.�:, ` City/State/ZiP C 1/ ��C /. i.tiF � g.� �' / <br />'LICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor�S Ag2�Y _ T2f18f1Y (must provide a letter of consent from the owner to do work in ihe space) <br />NTRACTOR j�/� �c% S 4%5 c;�a, S L& i Lic. # CtC,/�/5/ ���� I� �- COE Bus. Lic. # <br />ress �db 5 � 2 �j �"� 1� �, SG fi�i�C , Ckt�:%G ��F- Phone/Email �/,� S �- .� <� � . �. � � � <br />fl1 �� �; s o i.! ►/. �C �1 /� ��.r�,c�i �te,�;> <br />BUILDING PERMIT APPLICATION <br />/ �IL�ij ��,� L <br />'hone/E-mail %��S = J S �j � � % 1 .7 <br />�ONTRACT PRICE OF WORK KP�� <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New Addition Remodel Repair _ T.I. _ Sign _Sprinkle <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />��� ��`i�G/�/�� � V�1�0�' <br />�O�o�n��___ <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fi�riures <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 />Ranpe hood <br />Woodstove <br />Other <br />NKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />_ Electnc Other <br />olition ChanQe of Use <br />PLUMBING PERMIT APPLICATION <br />ofProject: _New_Addn _Alteration_Repair <br />Show Number (#1 of fixtures <br />en <br />�iotnes wasner <br />Water heater <br />Sink (servicelbarh <br />Backflow preventE <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease tra� <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 wrrect. All provisions of laws and ordinances goveming 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 lo violate or cancel the provision of any other state or local law regulating construction <br />Thal 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 />Owner/Authorized Age Signature Date (Revised 6/2012) <br />