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�� <br />� <br />PEF�MIT APPLICATION <br />BUILDING/MECHANICALIPLUMBING/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 />r� IPROPERTY TAX # <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />ress <br />'LIC/�NT: _ Owner _ Owner's Agent � Contractor <br />K�7►11:7_��[i7:7 <br />, <br />ress <br />l��Y��ey CA1� C�'F�c� <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building <br />Phone/E-mail <br />City/State/Zip <br />COf1tf2CiOf S/�g8flt _ TEIlBflt (must provide a letter of consent from the owner to do work in the <br />State Lic. # <br />'� I Phone/Email <br />TACT FOR PERMIT <br />�"�-J�C�►- � <br />� <br />�/ -mail ��C��� <br />'��ity Bus. Lic. # �?j�� <br />•'�$ �•7(a(a9 � �c.SSI <br />>> n�l _ <br />ONTRACT PRICE OF WORK 2, L�`X� <br />� <br />Proposed Use of Building I <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair � T.I. _ Sign Sprinkler <br />DESGRIPTION OF WrOR (additiona�l �sp�a e provided on the back): <br />f�'�i`��-�T�- 1.���� ��iE:.LJ�L./�..� <br />A,drJ. C2� ��15 <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 i inq <br />Water heater <br />Gas fireplace <br />� Gas range <br />� Clothes drver <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />Other <br />Chanae 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 />Shower <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 certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this type of work will be comp <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 lhe owner of lhis property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br />, %. <br />� <br />Ow er u orized Agen Signature Date (Revised 4/2015) <br />