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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 QM TO 4 PM <br />ADDRESS: <br />TAX # <br /># <br />LEGAL for new construction: Short PlaVsubdivision Lot No. (aitach copy of long legal description) <br />:R Z ,; <br />s � f�ti <br />CANT: Owner <br />��5 -,� � � - �'� c- 4- <br />�L <br />0 <br />Owner s Agent _ Contracior _ Contractors Agent _ Tenant (must provide a kner ot consent trom the owner to do work in the space) <br />CONTRACTOR �'�j� j�� fr <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building <br />L&ILic.# <br />COE Bus. Lic. # <br />1Phone/Email <br />T FOR PERMIT <br />���_r � l �� rt .7��' � S <br />;ai! �`i�j-���—Lj�C'� <br />CT PRICE OF WORK � � � �C� , � <br />HEAT SOURCE: <br />,� ,�-- ' 7 <br />Proposed Use of Building � 7�- �--� Gas Electric other <br />Building type: �/'Single Family _ Duplex Townhouse _ MuRi-Family _ Commercial <br />Type of project: _ New _ Addition Remodel Repair _ T.I. Sign _Sprinkler Demolition Change of Use <br />DESCRIPTION1OF WORK (additional spa1ce provid.ed on theq b1ackJ :� �� S CL�},�. �;� � ��--i 01G n} ���r� �'_ � �,�;.' �� (� c,+1 <br />'J J� 1�:�� 11 1 Y16 (} {�+rl� -� � %`T�.l i �_ J� '� l,l,l l �j �;�'�'�t� � �ti V �-i � � �l � � ✓}[ �.I,C;J�� �� �li \C.�T-t' <br />J � <br />1:�� Z d i i�� ��� �✓�.�� �/� �� c��,. �.,� � ve S�-� I ��� � t t,� rn�� � j `y- � jC �u %'t5.� �1.-(J �! u.-de eX /Si- i vK <br />I06��i ��Oc`t' ��� C)LI�L\ ���� )nJ�Ca.����'��i i� I.�' �ti �--�'�t %t' �.� <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (it) 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 />' Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />SPRINKLEIt I <br />Number of Heads <br />SYSTEM <br />of Project: _New _Addn �Alteration _Repair <br />Show Number (#) of fixfures <br />Toilet <br />1 8athtub <br />Lavatory (wash basin <br />Shower <br />Kitchen sink 8 dispos <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (servicelbar/moF <br />isackfiow preventer <br />Urina! <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other. <br />I hereby certAy that I have read and examined this app6cation and know the same to be true and conect. AY provisions of laws and ordinances goveming this type of work will be complied <br />with whether specified herein or not. The granting of a permit does not presume fo give autlwrity to violate or cancel the provision of any other state or lor,al law regulating construction <br />That I am authorized by the o roperty ta per(ortn Ihe work for which applicatim is made and I canply with ihe Stffie Contractors Law 18.27 RCW and 296.200A WAC. <br />1 f ; . � � ��z <br />.�� � % � <br />nerlAu rizeiY gent Signatu e Date (Revised 6/2012) <br />