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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 />ITE ADDRESS: , PROPERTY TAX # /� P,€RMIT # <br />� � l � ��-�� S< <c c�{' k��� �7C� ) `� �S �?�� � C' [, r> t' L •' ��� i � � � � �--�(�� �i�. <br />1L for new construction: Short Plat/subdivision D'��— Lot No. <br />`�� L <br />ER ��� f�,(1�-(� -�'.{,,�.�'1�j�� Phone/E-mail <br />;s �� ] �" ��L(,S��1G�� t-�%� City/Statelzip � <br />ONTRACTOR <br />(attach copy of long legal description) <br />�-�/��{ �� GC'L���% �(Gl.�t�'t`.� � Ci�V✓l <br />�-�-l�-L�.i`i , �� ��,�� �`' �7 <br />Owner's Agent _ Contractor _ Contractor�S A9Qf1t _ T2f18f1t (must provide a letler of consent 6om Ihe owner to do work in the space) <br />BUILDING PERMIT AP.PLICATION <br />L&ILic.# <br />Phone/Email <br />COE Bus. Lic. # <br />hone/E-mail J�-E�C�" � � � ' �?�' 1 <br />CONTRACT PRICE OF WORK <br />Existing Use of Building ( ��l �f•iL1 L l� 7��v/� 1 fiT'1�Gy ���, HEAT SOURCE: <br />1 <br />Proposed Use of Building S�� Gas Electric � <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) : ��"�,�,� ��� , j� ' ) <br />�'-`- �/ c.�Y-C' � `fC C%►'[ G' i �I(�: �� � . <br />1,'�`s1���+r�y 2x�- �;,�,4-i� � '�x� r�,��c���.� � � <br />�� '� 2 � � �-� �,-� <br />MECHANICAL PE RMIT APPLICATION PLUMBING PERMIT APPLICATION <br />of Project: _New_Addn _Alteration _Repair <br />Show Number (#J of fixtures <br />� A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater �..-_ � <br />� Gas fireplace � <br />Gas ranqe . „ <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />Bathtub <br />Lavatory (wash bas <br />Shower <br />Kitchen sink & dispi <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m� <br />Backflow preventer <br />Urinal <br />Drinkinq Fountain <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 lhe same to be true and correct. All provisions of laws and ordinances goveming this rype of work will be complied <br />wRh whether specified herein or not. The granting of a permit does not presume lo give authonty lo violale or cancel lhe provision of any other slate or local law regulating consiruction <br />That I am authorized by the owner of this property to perfortn the work for which application is made and I comply wilh the State Contractors Law 18.27 RCW and 296.200A WAC. <br />� n � ��' <br />� �� r � �� <br />O n rlAuthorized Agent Signature Date �� (Revised 6/2012) <br />