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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 />SI;E_ADDR�SS_ ���'���u IPROPERTYTAXk I PF�,MI�� h�, /\ <br />� S� �t^ ��� � l� � t�' U <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER � �I2� � V� Phone/E-mail �ii�ij. . � �Q� 1 '""�� ��G�� �OZ� <br />Address l /(N/'��i%� CityiState/Zip �%'tj��4 �V �L.� � �"/� � � �-% <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor's Agent _ Tenant �o,�5t Proo�ae � ietter or consem trom ma owr�er to do wn�x ir, u,d <br />CONTRACTOR G(�lf�i.(ytL� T 6 �I�� �/ /0 (ii/ State Lic. # City Bus. Lic. # <br />h+.r <br />Adtlress F'hone/tmatl <br />TENANT BUSINESS NAME CONTACT FOR PERMIT �Q t-��rly�,,�� �� t� <br />��� � (/ V�/l ��� Phone/E-mail ,l � ' ��-rl . � � � � �� rJ ra � S�1 C.�. <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 'L CSUO, U^D `d'�- <br />Existing Use of Building �liL� � HEAT SOURCE: <br />Proposed Use of Building ic-�"[� ►�� Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family Commercial <br />T e of ro'ect: New Addition Remodel Re air T.1. Si n S rinkler Demolition Chan e of Use <br />DESC� rRMP,TI`ON OF WORK (additiona'space provided on fh� �� �� N�� C.�GJ✓�-1 7�� �( (' <br />v� ����,.,,;��o� c�►� <br />�,_..,G. _•.,•• 1/ �{f l <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handlinq units <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />� SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _ New _Addn _Alteration __Repair <br />Show Number (#) of fixiures <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/eic.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be true and correct. �II provisions of laws and ordinances goveming this type of work will be comp <br />with whether specified herein or not. The granting of a permit does not presume to give authoriry to violate or cancel the provision of any other state or local law reguleting construction <br />That I am authorized by the owner of this properry to perform the work for which application is mede and I compry with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />Owner/Authorized Agent Signature Date (Revised 9/2014) <br />\4� <br />