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PERMIT APPL�I-G-A�ION <br />BUILDING/MECHANICAL/PLUMBIN SIGN PRINKLER/DEMOLITION <br />CITY OF EVERETT PE ERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 vwvw.everettwa.org <br />r� �� t�� �'� APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ADDRESS: PROPERTY TAX # P.FgRMIT # � <br />3!0 i�---����-�-l�-�$G✓D oouy9�000�I�o� `� r�[��-��f`�� <br />for new construction: Short PlaUsubdivision <br />� c�2 rd�s�f cN1�i'���� <br />No. <br />Phone/E-mail <br />ress 31%, (/Lc'?i�G✓��)/ �✓,!�' • ICitylState/Zip <br />'LICANT: _ Owner _ Owner's Agent �Contractor _ Contractor's Agent _ <br />RACTOR Ng�iaN�Yc 5��i� cvR� <br />S rass <br />l`j%�✓l� �J�9� l,� V s✓��6 <br />BUILDING PERMIT APPLICATION <br />& I Lic. # <br />_(attach copy of long legal description) <br />2�G— r� 9-3��0 <br />SE�tf1cE, 98to7 <br />T8fl8flt (must provide a letter of consent from the owner to do work in the space) <br />/✓/9�ll1SC�,3��1 j COE Bus. Lic. # <br />Phone/Email <br />�R PERMIT !��✓� ',�,,�,n��G�_ / <br />J �?J�'/ f� <br />ZaG� z�'Z-�TloO S��✓BZ�il9�o��lS��r <br />PRICE OF WORK G} �,�/J � <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 Remodel Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on tne back) : <br />ri✓��'�YK a�� r��G�F �,��c�' /LLh✓r7IN�T v/�N��Di�6� S�Cn�- <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handlin units <br />Forced air s stems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />' Boiler <br />' Refriaeration <br />Du <br />SPRINKLER / SUPPRESSION SYSTEM <br />II Number of Heads <br />HEAT SOURCE: <br />Other <br />Demolition Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />� Sink (service/bar/mop/etc.) <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 rea and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this type of work will be complied <br />with whether specrfied herei or not. The rpranling 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 authorized by the ne�f thiSproperty to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />g-��-�3 <br />re Date <br />(Revised 6/2012) � <br />�2 <br />