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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 />ADDRESS: <br />LEGAL for new construction: Short PlaUsu <br />nWNFR �/^!1� .n T, �I'� r 1�0 <br />PPLICANT: � Owner <br />ONTRACTOR ( i 1.� <br />dress <br />Owner's Agent <br />PROPERTYTAX# I PER�MI�T���' <br />9�ZCi3 0��9700UU/OG�D .��,� <br />�.. i��ot No.� (attach copy of long legal description) <br />Phone/E-mail y ' 2� <br />9 <br />City/State/Zip �i! p Z <br />Contractor _ Contractor�S A jEfll _ T811af1i (musi provide a letter of consent from the owner to do work in the space) <br />BUILDING PERMIT APPLICATION <br />State Lic. # City Bus. Lic. # <br />Phone/Email <br />CONTACT FOR PER4� �S�,Z <br />�,�.r�l.��Cc�enS <br />Phone/E-mail C�SS�CV�✓� � C��V • CU <br />CONTRACT PRICE OF WORK i"'. Cr � <br />Existing Use of Building I�C �Il��i l���!: � HEAT SOURCE: <br />Proposed Use of Building Gas_ Elec <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New _ Addition Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_ <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />Remale� eaci.5�f d«k. wh�k r�plac�,� ex�sfr'y wood w�� co�pa�si�r c�cc� , <br />rac�cndu•�� -ivp d�k.. owt 7�1. �'vr �, ct�.@ih�,.a.l ��,�j ,-J� ,+-f. <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 />j 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 />j Boiler <br />� Refrigeration <br />; Woodstove <br />Ductinq <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Other <br />Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _.Repair <br />Show Number (#) of fixtures <br />( Toilet <br />! Bathtub <br />I Lavatorv (wash basin) <br />Kitchen sink & disp� <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <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 ceRify 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 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 authorizeci by the owner of this property to periorm the work for which application is made and I comply witti the State Contractors Law 18.27 RCW and 296.200A WAC. � <br />l � <br />� �,� .��� �,�?//� <br />Owner/Authonzed Agent Signature Date (Revised 3/2013) <br />