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� <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: � PROPERTY TAX # PE T <br />lin I �% S �;ti� 'u�' �l' fi �� � i � �� `SL� tu I (:.>C% G ( S'1� c� '1 �� � <br />I <br />LEGAL for new construction: Short PlaUsubdi ision Lot No. (attach copy of long legal description) <br />OWNER j! � l 7 n.4��� �I V 1 f i1( i 1(� Phone/E-mail ��`)(,� '�'() � iS`�� � <br />APPLICANT: �Owner _ Owner's Agent _ Contractor <br />City/State/Zip <br />L L <br />COfltfaC�Of S Ag@Ilt _ T@f18f1� (must provide a letter of consent from the owner to do work in the space) <br />TRACTOR "V ° ��'L ' u �n� L& I Lic. #, i,•v j l;GQ j �� � L COE Bus. Lic. # <br />:ss �� r. /. %(� <br />tJ�i%'��' '"1� t% � �n+��,� � �/bli �% Phone/Email Zsl ' �-%.� � 7 � � % <br />4NT BUSINESS NAME CONTACT FOR PERMIT <br />���- �'�� �'�1��� <br />Phone/E-mail �L��' � `� �' ,,.- — �� � � � <br />BUILD/NG PERM/T APPLICATION <br />TRACT PRICE OF WORK <br />Existing Use of Building Y-�.'S -� � HEAT SOURCE: <br />Proposed Use of Buildinq��t�..r71 C �l%f� Gas Electric � 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 (additional space provided on the back) : � <br />'�Q.,�jGc�� �x� 5i, n�.�'i {ti � S U,� ,� b'l 4'�vt-�% � M L� �., �, �P��v� s, n� tv t' c�, s f� �ti 1 l <br />� � �U,,,�r, �; v,J � st- w a� �l . �c�--�tt�� �d r,n � � ��.1� <br />n �av �_ ;N � � �u �6�'�t� � � <br />i ,�� i <br />��, %� z� -� � u� �'' . n � � C.��—� n �i t� �� 1 _S �� 'V,, G, � b�tiL v� �� �� �Uv � 4 > � <br />� MEG�HANICAL PERMIT AP�L/CAT/ON PLUMBING PERM/T APPLICAT/ON <br />Type 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 ranqe <br />Exhaust fan <br />Unit heater <br />Boiler <br />Ketrigeration <br />Woodstove <br />Ducting <br />Other <br />1 SUPPRESSION <br />Number of Heads , <br />of Project: _New _Addn T Alteration _Repair <br />Show Number I#J of fixtures <br />Bathtub <br />Lavatory (wash basin <br />Shower <br />Kitchen sink & dispo: <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mo{ <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify lhat I have read and examined this application � nd know the same to be true and correcL All provisions of laws and ordinances goveming this type of work will be complied <br />with whether specified herein or noL The gran Ing of a perm' 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 o�er of t i prop rty to perfor the work for which application is made and I comply with the State Contrectors Law 18.27 RCW and 296.200A WAC. <br />. ���,+���% <br />1 � <br />nt Signature U bate (Revised 6/2012) <br />