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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 />� �v�i ! 3l; —vU i <br />IT DRESS: ���� ,� PROPERTY TAX q PERMIT # – <br />n <br />EGAL for new construction: ShoR PlaUsubdivision ��� Lot No. (attach copy of long legal description) <br />�WNER I- D�'�U�'(��r%� �T�� G:� Phone/E-mail �2 �'�-Z�'iCC.r2G�� I 1'�+YtJ�I�-�C'�`� <br />) �i/kar���. i� ; �,:.r. <br />ress <br />NT: <br />CONTRACTOR <br />�- C u-s �-� � <br />�wner _ Owner's Agent <br />� <br />Contractor <br />BUILDING PERMIT APPLICATION <br />ICity/State/Zip �����j� t V� (`�' �T �, `��' _7j <br />COf1tf2CtOf�S A9Ef1f _ T0f18n1 (must provide a letter of consent from the owner lo do work in the space) <br />State Lic. # <br />�Phone/Email <br />NTACT FOR PERMIT <br />CONTRACT PRICE OF WORK <br />Existing Use of Building �1 � l�� �1 i T/�L— <br />Proposed Use of Building 1��> (���i I lE�t_- <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 (a¢ditiona/ space provided on the back) : <br />Ik�%I�-t0 �� t(l�� I'}'(_,L. C�� �(� ►.i � 1� � J�`�.C`�1�- ''1�= ��' � <br />Citv Bus. Lic. # <br />HEAT SOURCE: <br />lectr � Other <br />olition Change of Use <br />(.��✓�=-�.---- <br />���' L;��tt���cN�� /�-� �_�z�{-�; j Z l:; C- ��t��: c�= E:����'� �,J��, .�t�J (�t-�SLI-�� , <br />MECHANICAL PERMIT APPLICATION PLUMBING 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 piping <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 />Boiler <br />; rcerngerauon <br />Woodstove <br />Ducting <br />( Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />� Bathtub <br />� Lavatory (wash basin) <br />j Shower <br />j Kitchen sink & disposal <br />� Dishwasher <br />� Clothes washer <br />� Water heater <br />; Sink (service/bar/mop/etc.) <br />i Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />;' Medical Gas <br />i 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 complied <br />with whether specified herein or not. The granting of a permit does not presume to give aulhority 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 applicalion is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />_����i� � ����ii`�G"" t � `� l l � <br />Owner/Authonzed Agent Signature Date (Revised 3/2013) <br />