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� � <br />PERMII' �4PPLICAI'ION <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 />ITE ADDRESS: <br />�(Z� �'�'�S ,:�-vc- <br />EGAL for new construction: Short PlaVsubdivision <br />�WNER �L�/1 .J :.�/"l.�% iO I�I <br />PROPERTY TAX # PE IT # � <br />�� �i��" � �� <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail Gc�C� "� G(:� ,� — / �� <br />City/State/Zip �(,��Ii1/`�- <br />PPLICANT: _ Owner _ Owner's Agent �Contractor _ Contractor�5 A92fll _ TBflaflt (must provide a lelter of consenl from the owner to do work in lhe space) <br />ONTRACTOR !/L�X�I'/' %�%�C��/ '� L� y� <br />� /U � c � State Lic. # ���������nG�7� it LBus. Lic. # <br />ss <br />E <br />� l`�' S� ,Su/ �Zu ; <br />BUILDING PERMIT APPLICATIOfV <br />�-�i� PhonelEmail ��j'" S� 1"-C�'7v 7 <br />CONTACT FOR PERMIT <br />PhonelE-mail � t%�N � �� � ` o � <br />CONTRACT PRICE OF WORK <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: �Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of projecL New =Addition� Remodel _ Repair =T.1. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />��_�voF � <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteretion _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />� Forced air systems <br />I Gas oipin4 <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 />Refriaeration <br />� Ducting <br />� Other <br />SPRINKLER / SUPPR�SS16I�1 Sl(SiEii� <br />� Number of Heads <br />I nereby certify that I have read and examined this p <br />with whether spec d herein or not. The granti of a <br />Thal I am author� J�hy thg owner of31`n�prop y to� <br />HEAT SOURCE: <br />Gas Electric Other <br />Demolition_Change of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />; Toilet <br />� Bathtub <br />� Lavatory (wash basin) <br />� Shower <br />� Kitchen sink & disposal <br />( Dishwasher <br />� Clothes washer <br />i <br />� Water heater <br />� Sink (service/bar/mop/etc.) <br />I Backflow oreventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />�n and know the same to be true and correcL All provisions of laws and ordinances goveming lhis type of work will be complied <br />does not presume to give aulhority to violate or cancel the provision of any other state or local law regulating conslruction <br />the work for which application is made and I comply with the State Contracrors Law 1827 RCW and 296200A WAC. <br />d Agent Signature Date (Revised 3/2013) <br />