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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 />SITE ADDRESS: � <r- <br />j c��`,— �� ��f:r�v: � Ic;w,�.: �ti �(- J�;-�t�t �; <br />LEGAL for new construction: Short PlaUsubdivision <br />OWNER �I�?X �-n���� %�� �� f"�cx�u <br />�p t �li��� <br />Address %i�Ci �� �> (.�/���,/Crc.:al,� /*ti�, I <br />PROPERTY TAX # <br />bEi�'i�o a - � <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail <br />City/State/Zip �- v'+=�" � � �� � �' Z'Z'� <br />LICANT: '� Owner _ Owner's Agent _ Contractor _ Contractor�5 Ag@Ilt _ T8f18f1� (must provide a IeUer o( consent from lhe owner to do work in the space) <br />CONTRACTOR U �'� °�%L-� <br />State Lic. # <br />hone/E-mail <br />Phone/Email <br />Citv Bus. Lic. # <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas Electric_ other_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. Sign Sprinkler Demolition_ Change of Use <br />DESCRIPTION OF WORK (additional space provide on the ck) : <br />U �� %�i� S� T�� � � C� � =� � ` `�� ' ��� ��� I � <br />t <br />n <br />��('\ �\±�C'� LL V1 � �� l�� . <br />�J <br />MECHANICAL PERMIT APPLICATION I <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C – air handling units <br />I Forced air svstems <br />Water heater <br />Gas firepiace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />� Refrigeration <br />j Woodstove <br />I Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />fJ„�, � C�,�� '� `�` �R� <br />C , `�� �: � i`� � <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />! Toilet <br />' Bathtub <br />I Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <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 hereipor 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 conslruction <br />That I am authorized by t owner of this propeRy to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RC W and 296.200A WAC. <br />, �� <br />-�' "�_ G Z ��V� �� ' <br />Owner/Au ized Agent Signature Date (Revised 3/2013) <br />