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• <br />• <br />PERMIT APPLICATIOtV <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 />SITE ADDRESS: <br />� I� I I �,.� c.�l �,v,�' <br />LEGAL for new construction: Short PlaUsubdivisic <br />'NER �.�bw�i� �d IJG{R'� L L � <br />ress ��l O )�1$}r' lji' �j� �' 2 d� <br />'LICANT: � Owner _ Owner's Agent _ Contractor <br />CONTRACTOR ��[� _ S <br />NESS NAM <br />RTY TAX # <br />PE MIT # <br />�tv l �o (o- <br />No. (attach copy of long legal description) <br />0 <br />Phone/E-mail <br />ICity/State/Zip �,� hYl1A�DQa �'� C1 g�� <br />Contractor�S A jBflf _ TBflBflt (musl provide a letter of consent from the owner lo do work in the space) <br />State Lic. # <br />Phone/Email <br />FOR PERMIT <br />Bus. Lic. # <br />Phone/E-mail �0� p�j � ��� � <br />BUILDING PERMIT APPLICA'i°IOfV CONTRACT PRICE OF WORK �' ��OO •�C� <br />Existing Use of Building �� � <br />Proposed Use of Building � � <br />Building type: %� Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project New Addition ,� Remode� Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�.osvre�`�� cemod�,) ry���►�aY � n�-c{�o,r wall a�'������o,ns <br />iYl � l� W G r�` 1�Pl Y1 ` � �,C.�C 1�•i �S1G� l n� � ���in �Y' �t� . <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _,Alteration _Repair <br />Show Number (#) of fixfures <br />A/C — air handling units <br />I Forced air systems <br />I Gas pipina <br />SPRIN <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Ducting <br />Other <br />� SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />G <br />Other <br />_Demolition_Change of Use <br />Y�C,w CG b�Y1G�-'S �� IOClY 1✓� � � <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn X Alteretion �Repair <br />Show Number (#) of fixtures <br />� Toilet <br />� Bathtub <br />I Lavatorv (wash basin) <br />snower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/e <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: m q �n I' � <br />Other: <br />I hereby certify that I have read and examined this application and know lhe 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 permil does not presume to give authority to violate or cancel the provision of any olher state or local law regulating construction <br />That I am authorized by the owner f this ropeRy to peRorm the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. ��' <br />� <br />/ � / �� <br />Owner/A orized Agent Signature Date (Revised 3/2013) <br />cn" <br />