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• <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 />SITE ADDRESS: PROPERTY TAX # oO�x►D?t (oa((b� PERMIT # <br />3v � ( gr�c�ocPw�er oo4'�to7sborloo �j ��%'r� � <br />LEGAL for new construction: Short PlaUsubdivision .S�E E/UGGOS� Lot No. (attach copy of long legal description) <br />s83a E��� <br />f: _ Owner �Owner's Agent <br />ONTRACTOR �V�F� W �T <br />F�ok 3535 /�r►zuNF�1oR/. �r�4- <br />Phone/E-mail � �- 42�i• ��'✓Q' ' �'(?(p% <br />City/State/Zip F���' W�t G%i2 20 3 <br />COf1tfBCYOf _ COf1Yf8CtO��S AgBllt _ TBf18f1t (must provide a letter of consent from the owner to do work in the space) <br />HoPEwon-tcs <br />BUILDING PERMIT APPLICATION <br />State Lic. #�1F1fiTWG lQjj{�L7 City Bus. Lic. # <br />ZZ �j Phone/Email 1�25 ZqD �'(p�j(p <br />CONTACT FOR PERMIT <br />Po�� �-{o�r�s, vYl�°�^'�+�-�T�S <br />Phone/E-mail 42S•?�9'3/(al G{ov �n�d �haN./�¢t <br />CONTRACT PRICE OF WORK ��D�G'LL"� <br />Existing Use of Building ����, i>F�%/i� HEAT SOURCE: <br />Proposed Use of Building �'r�L� �F�iG��, G/��'� Gas '� Electric_ Other_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family ✓Commercial <br />Type of project: New _ Addition _ Remodel _ Repair �%T.I. Sign _Sprinkler Demolition_Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />jN t�f?ro!�- ln�.�ivoV�?'"`'E�[''S, GG� V�S/a� DF �P�x 8�.+� S F S?D►Z� E� <br />�rr� (� z o��Pfw�Y ) <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 i in <br />Water heater <br />j Gas fireplace <br />� <br />Gas range <br />' Clothes d er <br />Ran e hood <br />Exhaust fan <br />i Heat pump <br />i Unit heater <br />i Boiler <br />� Woodstove <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />; Toilet <br />Bathtub <br />Lavatory (wash b� <br />Shower <br />Kitchen sink & dis <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 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 comp' <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 perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />w� � s. �9. Zo�s �� z- <br />Owner/Auth iz Agent ig ture Date (Revised 4/2015) <br />