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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />AC�DRESS:. ��� � PROPERTYTAX# PERMI # <br />Z S� S7- dosq3s6�9�q� �r�f Z- G�C-�(G� <br />GAL 1'or new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />✓NER c�v ' U � SU ( =v� � Phone/E-mail <br />i�ess (J.�? �a� :L33 City/State/Zip �°�S�(SV�'ll� W � � 9�.7v <br />PLIC,ANT: _ Owner _ Owner's Agent � Contractor _ Contractor�S Ag2flt _ T@I18f1t (must provide a letter of consent from the owner to do work in the space) <br />NTR�4CTOR M�Ye� 5�' �'�' A�V ��5� 1�l L& I Lic. # Me tss R�3 8 Lf COE Bus. Lic. # <br />Iress,�,U�� �wY � JO��c�`1..��McT��f`��� hone/Emall �p.iCl�Yjpw@ e$i .cpw1 <br />C �► — U� SU c�,� ��� <br />BUIL�ING PERMIT APPLICATION <br />NTACT FOR PERMIT �C•l� LY �C (� <br />�. � <br />/ � <br />nelE-mail OV' �Z�i– �325 b��i���1�1�YE�$�'�lil.� <br />NTRACT PRICE OF WORK Z,���� �— <br />Existing Use of Building �GT�� 1 � <br />Proposed Use of Building �t�'u: <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family �C Commercial <br />Type of project: _ New _ Addition _ Remodel _ Repair _ T.I. �C Sign _Sprinkler <br />DESCFIPTION OF WORK (additional space provided on the back): <br />i � 5�� � � �,I�l 5 � �ti <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fintures <br />A/C – air handling units <br />Forced air systems <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />� Other <br />�PRINKLER / SUPPRESSION SYSTE <br />Number of Heads <br />HEAT SOURCE: <br />Electric Other <br />molition Change of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />Bathtub <br />sh <br />Kitchen sink & dispo <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mo <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certiry 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 o( work will be complied <br />with whether specified herein or not. The granting of a permit does not presume to give authority fo violate or cancel lhe provision of any other state or local law regulating construcfion <br />That I am �iuthorized 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 296200A WAC. <br />�'�c�, � 2— � 1— l`-( ��7 <br />Owner/Avthorized Agent ignature Date (Revised 6/2012) <br />