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u <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 />ITE ADDRESS: <br />OPERTY TAX # <br /># <br />�lyb3 I/ic_7'�h� AG. �UE.2�y'1" wa- I I C��,t� l <br />LEGAL for new construction: Short PlaUsubdivision 13L �C 003 D`O� Lot No. /9'� (attach copy of long legal description) <br />�� <br />Th sr. <br />ONTRACTOR O W <br />BUlLDING PERMIT APPLICATION <br />PhonelE-mail <br />City/State/Zip Fl�,L 1 NE, To� , W <br />L&ILic.# <br />Phone/Email <br />� <br />hone/E-mail p1��16£L �/1'1/T�% �J�jO- 7/�_'�%!�d <br />ONTRACT PRICE OF WORK �D� DOC� <br />Existing Use of Building S��,j(�L� �AMtl�f (�f,t�i j�� �.1G5 <br />ProposedUseofBuilding 71�1� ��Mi�7 I��S11�i.1JG`L <br />Building type: Single Family uplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New _ Addition _ Remodel � Repair _ T.I. _ Sign _Sprinkle <br />Description of Work (additional space provided on fhe back): �����R ������7i�y� � <br />�GEGTRIGAL � �LH..r�rb.n�� - 12£�A,2 �,eo�v7 � 3��� <br />Have you started working without a permit? �YES _NO <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: �New_Addn X Alteration K Repair <br />Show Number (#) of fixtures <br />� A/C — air handling units <br />Forced air systems <br />YN ; Gas piping <br />N�w Water heater g� L 1 <br />� Gas fireplace <br />� Gas range <br />Clothes dryer / <br />� Range hood <br />N�/ Exhaust fan <br />Heat pump <br />�t/�,�,�/ Unit heater £�L � <br />� Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />Gas� Electric� Other <br />r _Demolition_Change of Use <br />[76tyw�4�/ lf,�A N�I.cJ <br />�J�ck.s � R�l�A,� �'i.�..v�' <br />PLUMBING PERMIT APPLICATION <br />Type of Project: �C New _Addn KAlteration _Repair <br />Show Number (#) of fixtures <br />/V�/ I Toilet <br />Nf�� Bathtub <br />�� � Lavatory (wash basin) <br />Shower <br />W Kitchen sink & disposal <br />ti Dishwasher <br />iv�W Clothes washer <br />N�w � Water heater ELL <br />� Sink (service/bar/mop/etc.) <br />N� � Backflow preventer <br />I Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />/ <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 <br />this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel <br />the provision of any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to perform the work for which applicatioP is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />_..) <br />� <br />i / <br />�-!� % � � !�' -' / 5" - / <br />.�-u <br />Owner/Author�d Agent Signature Date (Revised 2/2011) <br />