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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 />ITE ADDRESS: PROPERTY TAX #i PERMIT # <br />/ 7 i 6 ��k:�i,L�.�� y�ih' - c��v _�� 3Sic �-5« J�/�D 3- D L i <br />EGAL for new construction: Short PlaUsubdivision G�v• �%L%r �/`"�G�`� Lot No��`%� (attach copy of long legal description) <br />NER <br />Address <br />��-,�� �L c <br />� <br />APPLICANT: � Owner _ Owner's Agent _ Contractor <br />CONTRACTOR <br />TENANT BUSINESS NAME <br />�v�✓�t� c��� ,���� � � <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building /�'� <br />5 <br />Phone/E-mail <br />City/State/Zip <br />.�� . ��� ,� <br />�C' 1 ��//�C�}� � <br />Contractor�5 Ag@Ili _ T2�8flt (must provide a letler of consenl from lhe owner to do work in the space) <br />State Lic. # <br />Phone/Email <br />CONTACT FOR PERMIT <br />one/E-mail �la"� .S3 J .�-d��' � <br />ONTRACT PRICE OF WORK <br />Proposed Use of Building �"'"k .4 � ,�-�C�-`� �_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family� Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ 5ign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�P�v +'Fi� - -%�o� ���✓-� �i r� � O � r�C''C'"��� � � <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Sitow Number (#) of fixtures <br />I A/C – air handling units <br />� Forced air systems <br />� Gas pipin4 <br />; Water heater <br />Gas fireplace <br />I Gas range <br />! Clothes dryer <br />� Range hood <br />( Exhaust fan <br />Heat pump <br />� Unit heater <br />—� Boiler <br />� Refrigeration <br />i Woodstove <br />! Ducting <br />� Other <br />SPRINKLER / SUPPRESSION <br />Number of Heads <br />TEM <br />City Bus. Lic. # <br />-t;�`: (C- �c"�c-/, i�f'. %ie's? <br />HEAT SOURCE: <br />_ Electric � Other_ <br />olition Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />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 />I Urinal <br />i Drinking Fountain <br />; Floor drain <br />� Grease trap <br />I. Roof drains <br />I Medical Gas <br />i Other: <br />; Other: <br />I hereby certify that I have read and examined this application and know the same lo be true and correct. All provisions of laws and ordinances governing this lype of work will be complied <br />with whelher specified herein or 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 construction <br />That I am authorized by the owner of this propeRy to perform the work for which application is made and I comply with the State Contractors Law 18.27 RC W and 296.200A WAC. <br />� y <br />� f_- _ • , - ���%�- � � ��� / �� <br />Owner/Authorized Age�t Signature — Date (Revised 3/2013) <br />