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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: . PROPERTY TAX # PERMIT # <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER �1,i�'jtl.OdA� W H' rrl,�tr��.1 G Phone/E-mail i%js' 3�y ��� � 40 <br />APPLICANT: _ Owner _ Owner's Agent <br />CONTRACTOR <br />Address � 7 , <br />(J� e5`�Wr1, �GG <br />BUILDING PERMIT <br />/'o�,(wuY Sdslp . <br />Slr,ny�n 1'�s�•�a <br />AP LICATION <br />�'��p City/State/Zip �� <br />COf1t�8CtOf'S A9Bflt _ T2f18f1t (must provide a letter of consent from the owner to do work in the space) <br />' �+L & I Lic. # t%GYM �Gc. �'�5� COE Bus. Lic. # � (J'�' <br />(Z qk� r PhonelEmail ��5'3 ��ja �- � C�"/�^:%%/G..L <br />kz�3����7i <br />Phone/E-mail f i1�G/ <br />PRICE OF WORK <br />Existing Use of Building /ItCt,liGkl <br />� <br />Proposed Use of Building !(,l�Ltr� G <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family .1�'Commercial <br />Type of project: New Addition � Remodel Repair _ T.I. _ Sign _Sprinkler _ <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />5 e perwrt c� s��s ��-� � ���d t s'� h cc <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New_Addn Alteration _Repair <br />Show Number (#) of fixtures <br />NV-OII I1011 <br />Forced air sy <br />Gas piping <br />Water heater <br />Gas fireplace <br />Clothes drye <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />Other <br />� SUPPRESSION SYSTEM <br />Number of Heads <br />��— ���307 �' <br />� G . «J <br />� 6xc� <br />HEAT SOURCE: = M <br />7� Electric Other � � <br />Demolition Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: _New_Addn Alteration _Repair <br />Show Number (#1 of fixfu�es <br />Shower <br />Kitchen sink & dis <br />Dishwasher <br />Clothes washer <br />Water heater <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />F�oor drain <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 goveming this type of work will be complied <br />with whether spec�ed 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 />Thal I am authorized by the own s property to pe o e work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />O r Authorized A ent Signature � Date � (Revised 6/2012) <br />i (L <br />