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s <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 />ITE ADDRESS: �� ^ � � � ���� �� � PROPERTY TAX # P�MI� � �' L �V <br />L <br />LEGAL for new construction: Short PlaUsubdivision <br />ER <br />No. (attach copy of long legal description) <br />Phone/E-mail <br />idress �2'ZZ S. I ZO �1- �i • ICity/State/zip �q�� w� ��0�� <br />� <br />PPLICANT: � Owner _ Owner's Agent _ Contractor _ Contractor�S A92fli _ T2118f11 (must provide a letter of consent from the owner to do work in the space) <br />�� <br />ress <br />S��u �a�L ��a <br />BUILDING PERMIT APPLICATION <br />State Lic. # <br />Phone/Email <br />PhonelE-mail 1 V l.� � �� 6 <br />CONTRACT PRICE OF WORK , C <br />Existing Use of Building ✓ � <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: New Addition Remodel � Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additiona/ space provided on the back) : <br />� u �� �c�� �, �$ v�r d <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />� A/C - air handling units <br />I Forced air svstems <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 />i Refrigeration <br />Woodstove <br />Ducting <br />( Other <br />SPRINKLER / SUPPRESSION SYSTE <br />Number of Heads <br />Bus. Lic. # <br />HEAT SOURCE: <br />Electric Other_ <br />olition Change of Use <br />W� <br />I PLUMBING PERMIT APPLICATION <br />Type of Project: _New,�Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />I Toilet <br />wash <br />Shower <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/ <br />Backflow preventE <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby cerfify 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 pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />1r <br />�� � �, � I � � � <br />Owner/Authorized Agent Signature Date (Revised 3/2013) <br />