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� � <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 />ADDRESS: <br />PROPERTY TAX # <br />� �� <br />for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />owruER _ j �;. <br />Address ('�j�L� <br />APPLICANT: <br />CONTRACTORd <br />o,,,,r��.. -� ., , <br />�� � �%� Phone/E-mail �--�'�j"~— � 7 � , � � � �_, <br />'� � L i/ 1 /i l/ � City/State/Zi — <br />P U' � � <br />Owner _ Owner's Agent _ Contractor _ Contractor's Agent _ Tenant �m�si Pro��de a ieuer or �oosem rrom �ne ow�,e. io aa work ��, u,e <br />� <br />BUILDING PERMIT APPLICATION <br />Ebsting Use of Building _ X <br />Proposed Use of Building <br />Building type: �( 5ingle Family _ Duplex _Townhouse <br />�pe of project: New Addition �( Remodel Repair <br />DESCRIPTION OF, WORK (additional space provided on the back) : <br />�� �p �� �,`-'.M'G U <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of Fxtures <br />— � <br />A/C - air handlin units <br />� Forced air s stems <br />Gas pipin <br />—� <br />Water heater <br />� Gas fire lace <br />_ Gas ranqe <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />nerngera[ion <br />Woodstove <br />; Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />_ Number of Heads <br />State Lic. #�(`� jv,,;� �% I �I (J I� C City Bus. Lic. # c;� y'rj� � <br />� �PhonelEmail (,�Z� _ �' � � _ y �, `4 <br />CONTAC�T/ FOR PER�M7IT <br />✓�/ C-i / H.-�Cd :t L7 i L�!'/7 !°�` <br />Phone/E-mail `'�Z S — `"f Zv -�' `� � � <br />CONTRACT PRICE OF WORK `�l ,/; L(;C.C� <br />Multi-Family _ Commercial <br />T.L _ Sign _Sprinkler <br />HEAT SOURCE: <br />Other <br />Change of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn �C Alteration _Repair <br />Show Number (#J af fixtures <br />�C ! Toilet <br />)C ; Bathtub <br />Lavatory (wash basi <br />Shower <br />Kitchen sink & dispc <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mc <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 cert that I have read and examined this application and know the same to be lrue and correct. All provisions of laws and ordinances goveming this type of work will be comp <br />wilh whethe spec'fii in 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 construclion <br />That I a hori d by e owner of this property to perform ihe work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />r' <br />"�_ 9-.�-/s <br />Own r/Auth ' e Agent Signature Date (Revised 9/2014) <br />