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�_J <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.org <br />E ADDRESS: <br />.��a ���C�.. �� 'A�ti� . '� ��1 <br />iAL for new construction: Short Plat/subdivision <br />'NEFF����i:�,� �`'��i+�ia. <br />ress °-"lr��\4 �\"v �.�� �.V` Q � <br />�LICANT: _ Owner _ Owner's Agent Y Contractor <br />NTRACTOR <br />ress L\,?�?�- <br />TAX �i <br />Lot No. (attach copy of long legal description) <br />� <br />Phone/E-mail - " <br />City/State/Zip � <br />COf11f8C10f 5 Ag@f1t _ TBllBflt (must provide a letter of consent from the owner to do work in the space) <br />State Lic. # City Bus. Lic. # <br />� Phone/Email _ _ <br />CONTACT FOR PERMIT <br />�a.�i�.k. � �5'��-� " 'J'J'J �J <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ <br />Type of project: New Addition Remodel Repair <br />DESCRIPTION OF WORK (additiona� space provided on the back) : <br />_�%.'��a,�`�.��, �'v��..� �,`� �`� �'� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration �Repair <br />Show Number # of fixiures <br />A/C — air handlin units <br />Forced air s stems <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes dr er <br />Ran e hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refriqeration <br />PRICE OF WORK l��q\o . DC <br />HEAT SOURCE: <br />Multi-Family _ Commercial <br />T.I. Siqn Sprinkler <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatory (wash bas <br />Shower <br />Kitchen sink & dispi <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />inside <br />Ductin Roof drains <br />Other Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM Other: <br />Number of Heads Other: <br />I hereby certiTy that I have read and examined this application and know the same to be true and correcL 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 authorized 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 />Owner/Authorized Agent Signature Date (Revised 4/2015J <br />