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• • <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY C)F EVERETT PERMIT SERVICES <br />320Q Cedar 5t., Everett, WA 982Q'1 425-2�7-8810 FAX 425-257-8857 www.everettwa.org <br />ADDRESS: --2/a �� <br />'7 "� �� G--r l .�1r�. <br />1L for new construction: Short Plat/subdivision <br />�ss �3� �' <br />LICANT: Owner <br />NTRACTOR ii ii� <br />���� ��� <br />ress , <br /># <br />#1 I -F��� <br />No. (attach copy of long legal description) <br />�S 3�.�-��K ( �il((�dnC,��'�1��.��vr� <br />d(Ci,Y� � �City/StatelZip `� �� W .� 1 _C C>�� "� <br />_ Owner's Agent _ Contractor _ Contractor'S Ag@flt _ T@fl8flt (must provide a letter of consent from the owner to do work in the space) <br />: Ct�1lQ�� •'{ f L State Lic. # U City Bus. Lic. # b`{� / S� <br />t��'�U`j, ���i'C..�.i '�1Yltuu+c�, �U�r �''�,(�` )Lt Phone/Email``i �rl ������1 «� �K`ti�' <br />ME CONTA T FQR PERMIT <br />�L-I�-�� ��ts-�G���IIC�I(r�d�Lh���� c.�rn <br />BUILDING PERMIT APPLICATION <br />PRICE OF WORK <br />i <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas� Electric Other <br />Build�rrg type: _ Si'ngie Farrrify _ Dupfex _TowrrFrouse _ IE�ufti-Famify _ Gammerciaf <br />�pe of project: New Addition Remodel Repair T.I. Sign Sprinkler Demolition Chan e of Use <br />DESCRIPTION OF WORK (add"tional space provided on the back) :, <br />ln��ci,�i�n � �� ��� �c o� 5'��-'��- � �"��- <br />� <br />MECHANICAL PERMIT APPLICATION <br />pe of Project: _New _Addn 11 <br />Show Number (#) of 1 <br />A/C — air f <br />A Forced air <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />_Repair <br />units <br />s <br />i Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />I hereb certiFy t t I have ead and c <br />with w ether sp ified he in or not. <br />TF�t I� m autho i ed by tY�owner of <br />Signature <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of �xtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <br />Urinal <br />[1rinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />appl tion and know the same to be true and correct. All provisions of laws and ordinances goveming this type of work will be comp', <br />of a ermit does not presume to give authoriry to violate or cancel the provision of any other state or loral law regulating construction <br />to p rform the work for which application is made and I comply with the State Co�tractors Law 1827 RCW and 6200A WAC. � <br />���� �� S �� <br />� � <br />Date (Revised 9l1014) <br />