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� <br />� <br />PERMIT APPLICATION <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.o�rg <br />LEGAL for new construction: Short PlaUsubdiv <br />OWNER ���5 2e� /Nve�7 • <br />Address y So � N F I q o Tk �S � <br />APPLICANT: � Owner _ Owner's Agent _ <br />CONTRACTOR DI/r/V�� <br />ress <br />PROPERTY TAX # <br />�Zo / 00 �D/� �96 D Z <br />Lot No. <br />Phone/E-mail � <br />City/State/Zip , <br /># <br />G <br />(attach copy of long legal description) <br />7 q7y� �'opnotch�9��1%uP,�o <br />Contractor _ Contractor�S A98tlf _ T011Bf1t (must provide a letter of consem from the owner to do work in the space) <br />Lic. # <br />City Bus. Lic. # <br />IPhone/Email <br />CONTACT FOR PERMIT /1� � 2 S 7 ('' ��J� <br />3�llA�v Xd �y��� �. � T <br />Phone/E-mail / Q no tr-h �9@�%ve'`- Q� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK .`� C�OC1 Ot� <br />Existing Use of Buiiding c��� <br />Proposed Use of Building S�le <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition l� Remodel �' Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />HEAT SOURCE: _ <br />/� Electrid` Other <br />�molition Chanqe of Use <br />� e PA> �2 �7n��L t39� %�G f/ �/N/�'/fr� .�<S/Yl j, <br />�sF� �T`Ti4�f/�� Da Cs �R a �r, G/�y af" �Y�"�.�Tl •� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn X Alteration X Repair <br />Show Number (#) of fixtures <br />i <br />A/C — air handling units <br />/ Forced air s stems <br />Gas i in <br />Water heater <br />Gas fireplace <br />Gas range <br />/ Clothes dryer <br />4 Ran e hood <br />,3 Exhaustfan <br />f Heat pump <br />� Unit heater <br />Boiler <br />Refrigeration <br />' Woodstove <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Num6er # of fixtures <br />Toilet <br />J Bathtub <br />Z ' Lavatory (wash basin) <br />I i — <br />Shower <br />/ Kitchen sink & disposal <br />/ Dishwasher <br />/ � Clothes washer <br />Sink (serviceJbar/m <br />Backflow preventer <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 examin this application and know the same to be true and correct. All provisions of laws and ordinances goveming this rype of work will be comp <br />with whether specified herein or not T gr ting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law re�ulating construclion <br />That I am autho ' ed by the o er lhfs operty lo perform the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. <br />3%2�2�/S LI <br />wner ize Agent Signature Date (F!evised 9/2014) � <br />