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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: PROPERTYTAX# p� RMIT# <br />'.��� �,it9iZL�G%%Cc'_) ��< : �;�r��; _r�-, <br />for new construction: Short Plat/subdivision <br />ER <br />;ss i� /�i(S� !/ %//C�� <br />LICANT: _ Owner1 _ Owner's Agent � <br />TRACTOR <br />_Lot No. (attach copy of long legal description) <br />Phone/E-mail <br />P <br />-' � <br />Contractor _ Contractor�S A98flt _ T@f18f1Y (must provide a letler of consent from the owner to do work in the space) <br />��;� ��t �U��L`�/�` l��'� K�� <br />BUILDING PERMIT APPLICATION <br />L & I Lic. # <br />���d� Phone/Email <br />--------. . _... _....... 2?YiN <br />�L <br />Phone/E-mail �y.y,s � � <br />CONTRACT PRICE OF WORK <br />� <br />Bus. Lic. # <br />�t..- t7��vG� lSl'1 Lc�l7 <br />Existing Use of Building (i�1 G"LGY`j S��X / HEAT SOURCE: <br />0 <br />Proposed Use of Building Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family �ommercial <br />Type of project: _ New _ Addition _ Remodel _ Repair T.I. Sign Sprinkler �Demolition Change of Use <br />DESCRIPTION OF WORK,additional space provided on the back) : <br />��-��-�- �X��'i`� �.�vt7�'1 tL� �,,,/l �,'V'�� , _.r � x' � 1� ; '.'��"✓— <br />� - J �� �. � ��-��f "� i2'<c��llytitiLr�c.:; <br />i��-<' (� v,. < <T �.l 4., �� �r � <br />\ i3 Y✓y\.. L'` � L�..: I� c L ) `�� <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fiatures <br />A/C — air handling units <br />Forced air systems <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Boiler <br />Ductin <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />Shower <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: <br />Other: <br />I hereby ceRify that I have read and examined this application and know the same to be true and correct. All provisions of Iaws and ordinances goveming this type of work will be complied <br />with whether 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,9roperty to perform the work forwhich application is made and I comply wilh the State Contractors Law 18.27 RCW and 296.200A WAC. <br />,�I <br />�`/ �'� 'O � � <br />Owner/Authorized Age Signature Date (Revised 6/2012) <br />