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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.org <br />ADDRESS►- -�-�� � PROPERTYTAX# PE IT <br />.— > �� / `� �� �-�'�` �. ��/ Q ? - � ?� <br />1L for new construction: Short Plat/subdivision Lot No. (attach copy of Iong legal description) <br />WNER ��'i � t �I'�^✓�^�� ��--;%' l%, <br />idress ��� �--� f�.% f�i��/ i�P. C;a �• <br />PPLICANT: �wner _ Owner's Agent _ Contractor <br />ONTRACTOR � �J � ���="'✓'� �''^� <br />idress �(.� E � i/`i ���y 4,� v � <br />BUILDOt+IG P��tMIT APPLICATION <br />��� ���� �� � <br />�,/E-`_..^�;: � G�i / 7'F, <br />COf1lf8CtOf�S A90flt _ T8f18f11 (must provide a letter of consent from the owner lo do work in the space) <br />Lic. # <br />City Bus. Lic. # <br />C �� - c` '�� � <br />Phone/Email � _� � .J �.� � � �[ <br />ione/E-mail <br />ONTRACT PRICE OF WORK � <br />Existing Use of Building CJ— r�'�?�- � <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 (additiona� space provided o� the back) : _ ,! <br />� -����� �,-Q- � f- � G-�', � ��—�' ,��---�;` <br />, <br />�� -�--� y:�:- <��,�--;� `�( �e rn n�-e � i I -� � <br />HEAT SOURCE: <br />Oth <br />molition Chanqe of Use <br />f%�%� !it • ..-,� / �_ <br />p�e� n� a�w✓vin <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Nddn ^Alteration _Repair <br />Show Number (#J of fixtures <br />� A/C - air handling units <br />I Forced air systems <br />Gas piping <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 />Woodstove <br />Ducting <br />i Other <br />SPRINKLER / SUPPRESSION SYSTE <br />Number of Heads <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />� Bathtub <br />j Lavatory (wash basin) <br />i Shower <br />Kitchen sink & disposal <br />i Dishwasher <br />; Clothes washer <br />Water heater <br />; Sink (service/bar/mop/etc.) <br />i Backflow preventer <br />Urinal <br />Drinking Fountain <br />i Floor drain <br />Grease trap <br />Roof drains <br />'; Medical Gas <br />Other: <br />Other: <br />a <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 governing this type of work will be complied <br />with whether specified herein or not. The granting of a permit does nol 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 o 4his propert a perfor the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. � <br />� ! -• - / � <br />�- _ ��-� �4f z <br />� <br />� <br />Owner/Authorize, Age t Signature Date (Revised 3/2013) <br />