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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: PROPERTv rax # PBAtMIT.# <br />,� L <br />LEGAL for new construction: Short PlaUsubd <br />OWNER � /hi' 1 �iS <br />Address ��t,�� y i'%'1�y'FIC� (!`Ll��k.'. I�A�Gv y <br />APPLICANT: _ Owner _ Owner's Agent � Contractor <br />CONTRACTOR J�� �� �( �q ,S '�� <br />Address � O G S ��'�I /t4ti .S , l�%��jl-t ;� '� <br />l�� �/b l /� S <br />BUILDING PERMIT APPLICATION <br />Lot No. (attach copy of long legai description) <br />Phone/E-mail � y/Z S ' � �/� � ��yL <br />City/State/Zip / �C�7Z�TT" �-`� �/�'2� 3 <br />COf1t�8CtOf S f19ef1t _ Tef78f11 (must provide a letter of consent from the owner to do work in lhe space) <br />L& I Lic. # Ivl (-k-1l�C C. �%�%Z fli+�� COE Bus. Lic. #/ 7l a�I <br />Phone/Email 1c- � -- 7E•G ��/l <br />CONTACT FOR PERMIT <br />�_�%�Sli /�'G(,�,'.'.c:a?��Z�- <br />Phone/E-mail Z C E `j � 2- b`j b� l' �'Sc•, �� = tn� t�,ri S f• u• � s'� <br />CONTRACT PRICE OF WORK � ��, �qS� <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building 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 backJ : <br />� i � ��u N�; XiS i�aV � r� � � �. �-r���, � �� ►� y,;,�i�—�,�, i��►�r���t��� wr�r, �N �� s�� <br />t' 1 ���iG t, �in� ii � cn�� � �v � W � C>�►►r�t��-C �ri L �.0 fisi-Il�L- - T l E; i N TZ � 1e 1 S T`�n+ � i:,, �� <br />rt N J i�'-�..iv j� 1% l�Y E7�I. �- <br />MECHANICAL PERMIT APPLICATION <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 range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Unit heater <br />Boiler <br />Refrigeratio <br />Woodstove <br />� Other <br />RINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New �Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />Lavatory (wash basin <br />Shower <br />Kitchen sink & dispos <br />Dishwasher <br />Clothes washer � , <br />Water heater <br />Sink (service/bar/moE <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 />�r <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied <br />with whether specifed 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 the owner of this property to perform the work for which application is made and I comply with the State Con[ractors Law 1827 RCW and 296200A WAC. <br />/ Z � / <br />� " �� � Y <br />O er/ thorized nt gnature Date (Revised 6/2012J <br />