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ERMIT AI'PLIC�4T10 <br />BUILDIiVG/MECHAIVICAL/PLUMBING/SiGiV/�PRINKLER/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 />f.: i '� i�'I , �1 G � <br />DDRESS: <br />, '� a �'Yi x1a��f. `� � - <br />LEGAL for new construction: Short PlaUsubdivision <br />r..._ _ ,..---^ <br />OWNER�j'Ci�� �' I �� `'� 1 � L-- �--�L- <br />Address �v✓�� �,: `ji Y��� �✓ �1 ., <br />APPLICANT: � Owner _ Owner's Agent i� Contractor <br />CONTRACTOR <br />�A,� `,�,1 e�— <br />PROPERTY TAX # RMIT # <br />�s �s���a� ��. � �o -���-�-6e�-- <br />Lot No. (attach copy of long legal description) <br />�� � <br />Phone/E-mail ��(�CEtiG���:r� ::'��G;7Li ��'��� tT: ,Cr.i.7-Or\ <br />City/State/Zip �c b'� �,Ui,�L)���f � � -1 � ����+ <br />COfltfeCfOf�S A90�1 _ T2f18f1t (musl provide a letter of consenl from the owner lo do work in the space) <br />State Lic. #�T' ��TL��e`i� City Bus. Lic. # <br />Phone/Email ��i'-�l� r �, ��l <br />1 CIVHIV I 6UJIIVCJJ IVHIVIC �+v�� i r��+ � rv� r�n�r�i � <br />%_?S-' � h� (JC'.rv <�- v � <br />Phone/E-mail <br />BUILDING PERMIT APPLICA'�ION CONTRACT PRICE OF WORK ��5� G��.�-� <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas i� Electric_ Other <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New _ Addition �„Remodel _ Repair � T.L _ Sign _Sprin4der _Demolition_Change of Use <br />I�F: �'�?l,�Tpa"�!°� �'�_ !��ti..�f:Fn (additronal space provided on the back) : <br />(-�JS"Z-- 1tJT� �1 � P� �,�v1.e�t,L. (�/urr�h��-s j/r��7'�'� <br />���'a� iZ �1i>�� i ���"'�.� �.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 />L�� ; Gas piping <br />/ j Water heater <br />� Gas fireplace <br />/ I Gas range <br />; Clothes dryer <br />C � Rangehood <br />� � Exhaust fan <br />Heat pump <br />� Unit heater <br />; Boiler <br />; Refrigeration <br />� Woodstove <br />/ � Ducting <br />I Other <br />SPRINKLER / SUPPRESS <br />� Number of Heads <br />SYSiEM <br />'�.�.����cor2 �,c_;,4L..L G1'1cl�vct2S <br />PLUMBING PERMIT APPLICATION <br />Type of Project: �,New _Addn �Alteration _Repair <br />Show Number (#) of fixfures <br />Z � Toilet <br />Z I Bathtub <br />Lavatory (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 hereby certi(y that I have read and examined this application and know ihe 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 noi. The granting of a permit does not presume to give authority to violate or cancel the provision of any other slate or local law regulating construction <br />That I am authorized by ihe owner of this p opert a perform the work for which application is made and I comply with the Staie Contractors Law 1827 RCW and 296200A WAC. <br />� 1 <br />r / <br />� G�. <br />�l � lS� �Z ' <br />w r/Authorized Agent 5ign t e Date (Revised 3/2013J <br />