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ITE <br />� <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.everettwa.org <br />� i s' �(fi7vA4 h��Y <br />LEGAL for new construction: Short PlaVsubdivision <br />/ <br />PPLICANT: _ Owner _ Owner's Agent _ Contractor <br />ONTRACTOR <br />� <br />(,1FC <br />BUILDING PERMIT APPLICATION <br />TAX it I PER i IT�#!\ �_/� � I <br />� J �} l.L/ <br />i <br />No. (attach copy of long legal description) <br />Phone/E-mail <br />�� ICity/State/Zip <br />COIlifBCtOf'S Ag2flt _ T2f18f11 (must provide a letter of consent from ihe owner to do work in the space) <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ <br />Type of project: New Addition � Remodel Repair <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />RE�,or.� Q�ARte,�4 Q�r�r t �'-�sr,�<<.�,� <br />Mo,02 F r fc ��a2 ,Ok•f! •f Fx X v c i � ri � <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn �Alteration _Repair <br />Show Number (#) of fixtures <br />A/C – air handling units <br />I Forced air systems <br />i Gas piping <br />i Water heater <br />( Gas fireplace <br />i Gas range <br />Clothes dryer <br />; Ranae hood <br />Heat pump <br />Unit heater <br />Boiler <br />,/�' Ketrigeration <br />Woodstove <br />Ducting <br />j Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />State Lic. # <br />Bus. Lic. # <br />— Phone/Email ZS� _ � 7 Z <br />CONTACT FOR PERMIT <br />`,/�¢ y-- E Lv 2 niEL� <br />Phone/E-mail ,�(� �C ,y <br />CONTRACT PRICE OF WORK �/Z,3� OU� <br />HEAT SOURCE: <br />� Gas Electric Other_ <br />Multi-Family � Commercial <br />T.I. Siqn Sprinkler Demolition Chanqe of Use <br />G �%e�-r� ��'�t 9Lt.�,�' A'1E'/�� F- ,S6AFoa4 C.qsf - <br />cF. (���f���t� cC���� <br />—I PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />! Bathtub <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 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 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 property to periorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />�— t <br />O er/Authorized Agent Signature Date <br />(Revised 3/2013) <br />