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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: � � � <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />ER <br />_ Owner _ Owner's Agent _ Contractor <br />ONTRACTOR <br />�hone/E-mail <br />:i9Bftt _ T8f18�t (must provide a letter of consent from the owner to do work in the <br />State Lic. # �{ <br />� 1 Phone/Email <br />CONTACT FOR PERMIT <br />T� Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF <br />Existing Use of Building �� <br />Proposed Use of Building $ �� <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � <br />T e of ro'ect: New Addition Remodel Re air T.I. Si <br />DESCRIPTION OF WORK (additiona! space provided on the back) : <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn �Alteration _Repair <br />Show Number (#) of fixtures <br />� A/C — air handlin units <br />� Forced air systems <br />Gas pipin <br />Water heater <br />Gas fireplace <br />Gas range <br />! Clothes dryer <br />Ran e hood <br />Exhaustfan <br />Heat pump <br />! Unit heater <br />; Boiler <br />Refrigeration <br />W oodstove <br />Z ' other_d' �eu.ni.,n <br />SPRINKLER / SUPPR SION SYSTEM <br />Number of Heads <br />� �l(J City Bus. Lic. # <br />'� � O <br />� 1`IA. /n <br />� 30 � <br />. � <br />2 _157�b. <br />HEAT SOURCE: <br />Gas Electric Other <br />Commercial <br />_ Sprinkler Demolition Change of Use <br />��� a � �- <br />� ai� � <br />PLUMBING PERMIT APPLICATION <br />Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />Toilet <br />i Bathtub <br />! Lavatory (wash basin) <br />Shower <br />Kitchen sink & <br />Cloth washer <br />Water he er <br />Sink service ar/ <br />Backflow preve <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 goveming this rype of work will be comp <br />whether specified h or noL The grantinq of a permit does not presume lo give authonty to violate or cancel the provision of any other state or local law regulating construction <br />Tha a ed by t e ner of this operty to p rm the work for which plication s made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />' <br />erlAu ized Agent Signature Dat f' (Revised 9/2014) <br />�� <br />