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� � <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SF'RINKLER/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 />SITE ADDRESS: <br />1�-- l v C�. c�.+-� <br />LEGAL for new construction: Short PlaUsubd <br />� <br />IPROPERTY TAX q I PERMIT #� <br />'�k� �%C��l-3 )S 7�3`. ��r,c� �i <br />Lot No. (attach copy of Iong legal description) <br />OWNER � L ���; � Phone/E-mail � ZS- _ �'_ ', <br />� <br />Address � 'Z_ � o ,� �_ . � � City/State/Zip ` �.t-; _z t� �,, ; l � j ;Z O <br />APPLICANT: _ Owner _ Owner's Agent �COf1lf2Ci0f _ COf1lf2ClOf�S A98flt _ T2f18f1f (must provide a lelter of consent from the owner to do work in the space) <br />CONTRACTOR � ,,, -� ,-� � State Lic. # i�- A�,�, - �, -rc� ( � City Bus. Lic. #c , z � �. - <br />Address �o '7 � � � . _ , _. .�, ,. , ! . �r � il.. � ,.� - , � `, , , `` � n Phone/Email , � c . � (, �} t� � C_� � <br />BUILDING PERMIT APPLICATION <br />�Q.,..� t� �v�..21 <br />ione/E-mail �. , Z .� - S c � • ��, �' - <br />ONTRACT PRICE OF WORK � �1 �i �`- �. � <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />HEAT SOURCE: <br />Gas f Electric Ot <br />� .�, � . -, ,a L_` r__ c7� �� _. . - U 1 .i, -`�' _ -' ,." � �-C � \�c �-'`. <br />.���:. , o _,� `i� l �: <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn � Alteration _Repair <br />Show Number (#) of fixtures <br />i A/C -- air handling units <br />I Forced air svstems <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 />; Refrigeration <br />Woodstove <br />Ducting <br />� Other <br />PRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />of Use <br />( ��-��,.�.�� <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fixfures <br />� Toilet <br />� Bathtub <br />� Lavatory (wash basin) <br />j 5iio:^,�er <br />i Kitchen sink & disposal <br />Dishwasher <br />j Clothes washer <br />; Water heater <br />I Sink (service/bar/mop/etc.) <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 lhis 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 construclion <br />That I am authorized by the owner of this properfy to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />�d's�� ` L <br />Owner/Authorized Agent ignature Date (Revised 3/2013) <br />