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�ERMIT APPLICATIO <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 wvuw.everettwa.org <br />ADDRESS: <br />�. <br />TAX # <br />� <br />for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />WNER }� <br />idress �( : <br />PPLICANT: <br />ONTRACTOR <br />idress �`� <br />� <br />Owner _ Owner's Agent � Contractor <br />������- G��� <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building <br />Phone/E-mail <br />City/State/Zip <br />COflif8Ct0��S fig2flt _ T2fl8flf (must provide a lerier of consent from the cwner lo do work in the space) <br />State Lic. # <br />Phone/E-mail <br />Bus. Lic. <br />�'��E�i� 5�10 <br />a�- ��-a -�w� <br />�----�-< <, - � <br />CONTRACT PRICE OF WORK <br />,T SOUR�E: <br />Proposed Use of Building_��(V�Y�f`Q,'(lU(A.,� � Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: New Addition Remodel Repair T.I. Si n Sprinkler Demolition Chan e of Use <br />DESCRIPTION OF WORK (additional space provided on the back) :�1(���,� '�t�� (�y�;���(� �� ��jr�} <br />��rn`prcU�.vv�'�,��. ��. � bS`Q�� r�bv� E�"c�'�l)..��jt '�e��l , E�-rl�e..v�'�CM �\\� Sc-���W� w��.-� <br />�c,�w� t.����I���� a`�r `c�a�.r c�\� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn �Alteration _Repair <br />Show Number (#) of fixtures <br />� A/C — air handlin units <br />Forced air s stems <br />Gas pi in <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes d er <br />Ran e hood <br />Exhaust fan <br />� Heat pum <br />� Unit heater <br />Boiler <br />Woodstove <br />Ductin <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of He�ds <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />I Bathtub <br />basin <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.; <br />Backflow preventer (inside <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 governing this type of work will be comp <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 uthorized by the owner of 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 />, � ��ll� � � � <br />w er/Authorized Agen ignature Date (Revised 4/2015) <br />