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� • <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:� <br />; .�``�Z. S�� �) �Sa� <br />PROPERTY TAX kt <br />P. <br />�� <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER l�� `�J Phone/E-mail <br />Address City/State/Zip <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor�S A90f1Y _ TBI12flt (must provide a lette� of conseN from lhe owner to do work in the space) <br />CONTRACTOR F A(`,X�(=i�� `(�v��; , State Lic. # City Bus. Lic. # <br />ress <br />� � ���(,i <br />BUILDING PERMIT APPLICATION <br />Phone/Email ��S ' 3 l` -� - j���" c-�� <br />CONTACT FOR PERMIT <br />2 � �- -, �-, - <br />Phone/E-mail L� �� � J � � � �'-� � <br />CONTRACT PRICE OF WORK ;�c� r��� <br />Existing Use of Building �'�f�/�7�11%(SE=- <br />Proposed Use of Building r� � <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 on the Back) : <br />I��'l;v � � �" {-i -�-. , .r� � —, <br />�'-� r�� �� C_ I c.., t-t�"c,l—t ��� :� :-'�,_,< <.T�. <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixiures <br />A/C - air handling units <br />i � Forced air systems <br />j Gas piping <br />� Water heater <br />; Gas fireplace <br />i Gas range <br />' Clothes dryer <br />Range hood <br />L, ; Exhaust fan <br />j Heat pump <br />i Unit heater <br />Boiler <br />Woodstove <br />Ducting <br />i Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />_ Electric�L Other_ <br />olition Chanae of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />Bathtub <br />h <br />Shower <br />Kitchen sink & dispo <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mo <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 governing this type of work will be complied <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 authori d by the owner of this property to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />/_s%,_� <br />Owner/Authorized Agent Signature Date (Revised 3/2013) <br />