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�J <br />� <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 www.everettwa.org <br />SITE ADDRESS: <br />LEGAL for new construction: Short PlaUsubdivisio <br />OWNER K,yyN � <br />Address �2R M � <br />APPLICANT: �Owner <br />CONTRACTOR <br />4ddress <br />Owner's Agent <br />PROPERTY TAX ti <br />IT # <br />>�'! ��oi�o0 �taO � i/l ��-' <br />ot No. (attach copy of long legal description) <br />Phone/E-mail y �-� ��"Q <br />� City/State/Zip ����-�-�-� „V R � 8 2 D� <br />Contractor _ Contractor'S A9Bfll _ TeflBflf (must provide a letter of consent from the owne� to do work in the space) <br />State Lic. # <br />Phone/Email <br />Bus. Lic. # <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK (C����'�-' <br />Existing Use of Building pU ��—��C HEAT SOURCE: <br />Proposed Use of Building [� U��X Gas� Electric�J Other <br />Building type: _ Single Family �Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition � Remodel Repair _ T.I. _ Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additiona� space provided on the back) : <br />��n�r o �� � l�, rz�+-�N Mo d�ti1� s� �lr KS, �oD� rv � B� rTf� w.� ��, <br />M �D/Fy/NG �iN77�/ ��/t'�OVlNG C�-m$',�% -- <br />/ <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />i A/C — air handling units <br />� Forced air systems <br />i Gas qipina <br />vvater neater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Rangehood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />Ducting <br />j Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />i Toilet <br />i Bathtub <br />i Lavatory (wash basin) <br />j Shower <br />I ; Kitchen sink & disposal <br />� Dishwasher <br />' Clothes washer <br />; Water heater <br />� Sink (service/bar/mop/etc.) <br />', Backflow preventer <br />Urinal <br />Drinking Fountain <br />j Floor drain <br />Grease trap <br />Roof drains <br />j 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 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 ihe 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 />2 3 -��� - �/�� <br />Own / thori e gnature Date (Revised 3/2013) <br />