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• <br />� <br />L J <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 />r G <br />ADDRESS: — PROPERTY TAX # PERMIT # <br />r��.`7i �(=l� �L��`S; �uC ��� ���s c i �v'�. l,l � i ;G �(..'C� � <br />EGAL for new construction: Short PlaVsubdivis <br />0 <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor <br />CONTRACTOR <br />ress <br />BUILDING PERMIT APPLICATION <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail ( — (J Z , �i <br />City/State/Zip � ct /Z ( �l�l. � �'; G" � <br />ContractoPS A92�1 _ T2118f11 (must provide a letter of consent from the owner ro do work in the space) <br />State Lic. # <br />Phone/Email <br />hone/E-mail C��V���� <br />ONTRACT PRICE OF WORK <br />Existing Use of Building � <br />Proposed Use of. B/uilding <br />Building type: V Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkier <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />l. i2-� W��-u— i j1�-54yYti`Lb� 1 <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fixtures <br />A/C - air handling units <br />i Forced air systems <br />j Gas piping <br />i Water heater <br />Gas fireplace <br />� j Gas range <br />Clothes dryer <br />Range hood <br />; Exhaust fan <br />� Heat pump <br />i Unit heater <br />Boiler <br />Woodstove <br />Ducting <br />j Other <br />SPRINKLER / SUPPRESSIO� SYSTEM <br />Number of Heads �` <br />Bus. Lic. # <br />HEAT SOURCE: <br />Gas Electric Other <br />Demolition Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />� Toilet <br />; Bathtub <br />( Lavatory (wash basin) <br />� Shower <br />i Kitchen sink & disposal <br />� Dishwasher <br />; Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />i Backflow preventer <br />unnKing rou <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 governing this type of work will be complied <br />with whether specified herein or not .me 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 />-fih I am authorize y wne of this prope y to pertorm the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. <br />\ � <br />�- �_, � <br />Owner/Authorized Agen ignature Date (Revised 3/2013) <br />