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. > <br />• • <br />P��?"�!� �:P��!��T!��! <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />.'S%�I11 redar �T..� �VP�PTT� �/�: �TS%I7� 4L"TJ'%'�1%-�R��1 f F%�j� [.L%Vl-%'17-j,SYSh% V1/1AMf,P�JP�PTPN.�.Qr� <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: PROPERTY TAX # PERMIT # <br />?� i C3� �i: or�.+�W;,�n,l L u� .'�� <br />LEGAL for new construction: Short Plat/subdivision Lot No.__ (attach copy of long legal description) <br />� � �, Phcr.e;E-mail �fZS " 25Z' 'rJ �3� <br />��ntr��� rfY�t �'�ta.�n �e��''� Vn.�� o._ <br />Address ��n �P,� �, ��: ir.� 1 � �P`t City/State2ip i:= �(Z¢G'� �ls ���� j <br />APPLICANT: Owner _ Owner's /�gent � Contractor __ Contractor s Agent _ Tenant i����s� vr����e =!�nN� �r ��o„se�,i r� ��n !�,� �.k�,e� w d� wo�k n: me �u�,�e) <br />RACTOR �AC.,�b5(7�-� �CC�'L�h� c c., I <br />S'�2� 3 Iv7� a,Je. S �. Lax� S+'a�v�N> <br />NT BUSINESS NAME <br />Y�n�ll +t;� � (',�z d � � i.��� � �� <br />BUILDING PERMIT APPLICAiION <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: _ Single Famiiy _ Duplex Townhouse _ <br />Type of project: _ New _ Addition _ Remodel _ Repair <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn �Alteration _Repair <br />Show Number (#) of �xtures <br />� A/C - air handling units <br />� Forced air systems <br />I Gas aipinq <br />� Water heater <br />i Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />T Exhaust fan <br />Unit heater <br />Boiler <br />� Woodstove <br />Ducting <br />, Other <br />SPRINKLER / SUPPRESSI <br />Number of Heads <br />SYSTEM <br />L& I Lic. # SAC C> Ej Tt1'[ �� � Z� COE Bus. Lic. # <br />6a$(� lPhone/Email ��7.5` ,?jZZ- `-�C]le�i <br />)NTACT FOR PERMIT � I� I � �� A � v� S o n �r.Q <br />r-y�-- ?'��- ll��� �C�✓Y� <br />one/E-maii �� <br />)NTRACT PRICE OF WORK <br />HEAT SOURCE: <br />Multi-Family _ Commercial <br />T.I. Sign _Sprinkle <br />of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />j Bathtub <br />I_avatorv (wash basinl <br />Shower <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (servicelb� <br />Backflow prevei <br />Urinal <br />F{oor 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 We and correct. All provisions of laws and ordinances goveming this type of work will be complied <br />with whether specfied herein or not. The granting of a permit does not presume to give authority to violate or cancel [he provision of any other state or local law regulating construction <br />Thal I am authorized by the owner of this property to perform the work for which application is made and I comPly with Ihe State ConVactors Law 18.27 RCW and 296.200A WAC. <br />OwnerlAuthorized Agent Signature <br />Date <br />(Revised 6/2012) <br />t�Z <br />Cw� <br />