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• • <br />PERMIT APPLICi4TION <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 />ITE ADDRESS: <br />LEGAL for new construction: Short PlaUsubdivis <br />PROPERTY TAX # <br /># — — <br />No. (attach copy of long legal description) <br />hone/E-mail <br />0 <br />jdress �City/State/Zip <br />PPLICANT: _ Owner _ Owner's Agent � Contractor _ Contractor�5 A9BIlY _ T2f18f11 (must provide a letter of consent from the owner to do work in the space) <br />ONTRACTOR ��k �,���r��;141 �'v t��(i� LL- L State Lic. #�`•?`1-,,•_a� h��R�7�L I City Bus. Lic. # <br />S NAME <br />Phone/Email <br />,�,k� ���;� <br />Phone/E-mail �,- j' , <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building f�rrr,,v ��_,� <br />Proposed Use of Building ��� <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family �Commercial <br />Type of project: � New Addition Remodel Repair T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�a,� C�-e. - `��- <br />� � l �Z- lc� ��r,��f � <br />���c�: �ti�41%,1+;� M r� w �i� <br />� <br />HEAT SOURCE: <br />Gas Electric Other <br />olition Chanqe of Use <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures Show Number (#) of fixtures <br />� A/C — air handling units � Toilet <br />! Forced air systems I Bathtub <br />' Gas oipina I Lavatory (wash basin) <br />➢ <br />Gas fireplao <br />Gas range <br />Clothes drye <br />Range hood <br />Exhaust fan <br />Unit heater <br />Boiler <br />; Ketrigeration <br />Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Shower <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Backflow pre <br />Urinal <br />Drinking Fou <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 currect. 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 lhe owner o this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />_ .���f, `. % '""�Y �"�2� <br />or zi ed Agent Signature Date (Revised 3/2013) <br />