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� � , <br />� 1���� D� <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.evereitwa.org <br />SITE ADDRESS: PROPERTY TAX H P M� # n���\ --r <br />(Z�l ,M�v�s��f�f ��T :� �� ���� a-�d -rc����� i1���- �I (� <br />LEGAL for new construction: Short PlaUsubdivision <br />OWNER �Y=�"y' �-��'a �c:� , <br />Address +2� ,�•�-�j,�jlCfv� j � 'L'� �� <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor <br />CONTRACTOR <br />BUILDING PERMIT APPLICATION <br />Lot No. (attach copy of long Iegai description) <br />'T iI 5 ; �� J�"f _ j <br />Phone/E-mail - �K� �„✓(�j '� <br />City/State/Zip ����� �'l.r��v �'% �n��� <br />Contractor�5 A9@f1i _ T21l8f1Y (must provide a letle� of consent from the owne� to do work in the space) <br />State Lic. # <br />Phone/Email <br />Phone/E-mail <br />CONTRACT PRICE OF WORK <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ <br />Type of project: New Addition Remodel _ Repair _ T.I. _ Sign <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�Wii�(� R"��ti��Q-c:�,r� vv,;�.`12.� '�.x iS; 7�;i.�, U�'�cf-�- <br />L�r'`�i�I�� �A-1�'-fr�C�� L.���%- <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />� A/C - air handling units <br />� Forced air systems <br />j Gas piping <br />; Water heater <br />1 I Gas fireplace <br />; Clothes dryer <br />Range hood <br />-� Exhaust fan <br />j Heat pump <br />I Unit heater <br />� Boiler <br />; Refrigeration <br />Woodstove <br />Ducting <br />I Other <br />SPRINKLER / SUPPRESSION <br />Number of Heads <br />EM <br />Bus. Lic. # <br />HEAT SOURCE: <br />Gas Electric Other <br />Commercial <br />Sprinkler Demolition Chanc7e of Use <br />� <br />!�t t � I�i �;� 1, ���t���` i L <br />PLUMBING PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />� Bathtub <br />l I Lavatorv (wash basin) <br />5nower <br />Kitchen sink <br />Dishwasher <br />Water heater <br />Sink (service/bar/mo <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 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 the owner�i- roperty to peRorm the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. <br />% <br />� � � � ��� � ��. '/ 7 <br />Owner/ uthori > gent Si nature Date (Revised 3/2013) <br />