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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 />ADDRESS: <br />� � Z � �b U'�' . �"� <br />PERTY TAX # <br />b �'� --C� ( <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />� L� <br />OWNER ��„\ i,t L ITC% Phone/E-mail <br />Address ���� Z-� � j Z�l �� City/State/Zip C�[? t� �; �- C� � J % , <br />APPLICANT: _ Owner � Owner's Agent _ Contractor _ Contractor's Agent _ Tenant �m�s� prov�de a iener ot consenc trom tne owner co do work in me 5pa�a� <br />CONTRACTOR <br />�j (.0 �'-� � �� (� l.� ��!z � i,' � L' <br />BUILDING PERMIT APPLICATION <br />State Lic. # <br />�Phone/Email <br />FOR PERMIT <br />Phone/E-mail <br />CONTRACT PRICE OF WORK <br />Existing Use of Building ji <br />Proposed Use of Building � <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: New Addition Remodei Repair _ T.I. _ Sign _Sprinkler _ <br />DESCRIPTION OF WORK (additional space provided on 1he back) : <br />� „�� �;, � S� � �.1,�cL � �, �. �� �? ��� <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 />' Gas oinina <br />Water heater <br />Gas fireplace <br />Gas ranae <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />Ducting <br />� Other <br />KLER / SUPPFtESS10N SYSTEM <br />Number of Heads <br />Bus. Lic. # <br />HEAT SOURCE: <br />Demolition Chanqe of Use <br />i�� �/ '�� � 1ti'�<z.i--U� <br />"t <br />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 & di: <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/ <br />Backflow preventi <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 peRorm lhe work for which application is made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. <br />Owner/Authorized Agent Signature <br />� 7,tJ ( � �-"� <br />Date <br />(Revised 3/2013) <br />