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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.everetiwa.org <br />SITE ADDRESS: .� " PROPERN TAX #� p � p p PERMIT # <br />l �.�?�0� '� �u� ��:- `�j��y�' ���ci� � � z. <br />LEGAL for new construction: Short PlaUsubdivision ��� ,.j._ �''� Lot No. � (attach copy of long legal description) <br />OWNER � ~ 7 �� � �/3 �� Phone/E-mail p�G� 7 .�j � V`r � + n � (Y1G(1'1 � '' ' ' �,p� <br />Address ��-- %(J � v � ���'1/�— �� City/StatelZip �l ���t;l�� G � � C ��, ' ��l � �'� <br />APPLICANT <br />CONTRACTOR <br />Owner _ Owner's Agent _ Contractor _ Contractor�S Ageflt _ Te�aflt (must provide a letter of consent (rom lhe owner to do work in the <br />c�i��' �� ��/ r�~'� `� 1"� State Lic. #� City Bus. Lic. # <br />— - - , � - <br />, IPhone/Email <br />� . . <br />Inn '�iC;��TI� –} �l <br />� � �V`' l S .� � � Phone/E-mail � ` �r� "� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �� � <br />Existing Use of Building 2 <br />Proposed Use of Building !��i���V ' M': � H.tJM� <br />Building type: V Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition �Remodel Repair _ T.I. Siqn _Sprinkler <br />DESCRIPTION OF WORK (additiona/ space provided on the back) : <br />� C:� l� U�'.'� �.: A! ltc°ay �. � �t �o � L�-�� r��r�� <br />_ _, <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C - air handling units <br />Forced air s stems <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes d er <br />Range hood <br />R Exhaustfan <br />Heat pump <br />Unit heater <br />I Boiler <br />Woodstove <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />�U� ���� <br />�., <br />�% � .. <br />HEAT SOURCE: - <br />Other <br />_Demolition_Change of Use <br />�•�1r t�� - 4 <br />��e�� b�:;r,,�v'� \ '�. �� <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/e <br />Backflow preventer <br />Urinai <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 correcl. All provisions of laws and ordinances governing this type of work will be compl <br />with whether specified herein or nol. The granting of a permit does not presume to give aulhorily to violate or cancel the provision of any other sfate or local law regulating construction <br />That I am authorized by the owner hi�property to perForm the work forwhich application is made and I comply wilh the Slate Contractors Law 1827 RCW and 296.200A WAC. <br />� <br />� <br />Owner/Authori A' nt gnature Date (Revrsed 9/2014) � <br />., Z <br />