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ERMIT APPLICATIO <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 vwvw.everettwa.org <br />ITE ADDRESS: PROPERTY TAx # PERM,u� <br />v��3113:CC41�t':yr tv�-�c�k,'WPc 98zc:� ���;3tit�TS�:c��oc;fsl��-i��'��ayi�c;�v� � �`�(����,�, <br />EGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />ER f'�p�"�J <br />� <br />APPLICANT: _ Owner _ Owner's Agent �Contractor <br />CONTRACTOR <br />Address Z%�j�J <br />(��:�,JGrks .�:C'��1 .�.-,��er�►.se5 <br />BUILDING PERMIT APPLICATION <br />Phone/E-mail ��S"-%5`I' 65` �%h '�� GY� <br />�J <br />City/State/Zip ' e"�'-i- ' ! � �`,�('jl <br />Contractor�S A9@fll _ TEflBflt (must provide a letter of consent from the ovmer to do work in the space) <br />State Lic. # W � ' — " '� j � v City Bus. Lic. # �j , 4, ;'�" <br />�ii? Phone/Email .�id —7`ilv��d�5w ;h"�o� C�{Cf�7SGk,rth ,�G;'1t <br />CONTACT FOR PERMIT <br />..T��>'n �I ��ie� <br />Phone/E-mail :3ivG'a�f 3(Z�� 5. G�SYI�VJ��Yl�15G1�'.1ri f1C �CLf� <br />CONTRACT PRICE OF WORK ��''—r .��_� _'"� ���°�%, ` <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 _Sprinkle <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />lr���}�aliwht,r� � �' `�. �i }.�r) S�:IU-� �� �y��km r�� �r�t�-� <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C – air handling units <br />� Forced air s stems <br />Gas piping <br />� Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes d er <br />Ran e hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />( Boiler <br />€ Refrigeration <br />i Woodstove <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: f'" <br />Electric Other <br />�molition Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />! Toilet <br />Bathtub <br />! Lavatory (wash basin) <br />': Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.; <br />Backflow preventer (inside <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 t at I ha e ead 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 s cified e in 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 auth 'zed by h o�er of ihis 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 />�. I,"s'�°' ,� � 1 � ,� �I 2 b I �i � � � l <br />Date (Revised 4/2015) <br />