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• <br />� <br />PERMIT APPLICAiION <br />BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 vwvw.everettwa.org <br />SITE ADDRESS: �" --� ;—� ^/y �-- � ,_„_. <br />C/ �� /L�/ [�C � �' � . <br />LEGAL for new construction: Short Plat/subdivision <br />OWNER <br />ress <br />.� <br />PROPERTY TAX # I P MIT # <br />UL��s ��o�ioUv v� .�/1 I� I I- <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail �?��,5 � �� Z � <br />City/State/Zip ��'-�E-`�� ��� ��, �� <br />APPLICANT: �Owner _ Owner's Agent _ Contractor _ Contractor�5 Agcfli _ T@f12f1t (must provide a letter ofconsentfrom the owner to do work in the space; <br />CONTRACTOR ��% State Lic. # City Bus. Lic. # <br />4ddress Phone/Email <br />TEt�ANT BUSINESS NAME CONTACT FOR PERMIT ,.-- <br />%%�` ,�—/- / Q%�� ��� �� <br />�/�, < l / �� l�" / � (�(/ c� �'� /� <br />Phone/E-mail / �5, .7L�1� �j j ��� �O/��/������// �� <br />BUILD�NG PERMIT APPL�CATION CONTRACT PRICE OF WORK ��S . t� <br />Exis`ing Use of Building �%�� <br />Proposed Use of Building � <br />Building type: _ Single Family _ Duplex _Townhouse 1� Multi-Family _ Commercial <br />Type of project: _ New _ Addition Remodel �Repair T.I. Sign Sprinkle <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />��f.���l �'`� f�T ���%�"�l, ' ���%�/1. : <br />MECHANICAL PERMIT APPLICATION <br />ofProject: _New_Addn _Alteration_Repair <br />Show Number (#) of fixtures <br />A/C — air handlin units <br />Forced air systems <br />Gas piping <br />� Water heater <br />Gas fireplace <br />Gas ran e <br />Clothes drver <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />Gas Electric Other <br />_Demolition_Change of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration V Repair <br />Show Number (#J of fixtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/e <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 woric will be compl <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 a th ' ed 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 296200A WAC. <br />1 � /�. /-/" <br />� Ownerl o zed Agent Signature Date (Revised 9/20i4) <br />