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• � <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 />TAX # <br />� <br />PERMIT # <br />for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER <br />Phone/E-mail LL�L, � :,( /(e � <br />�� � <br />;ss �520 W � �L S� ICity/State2ip S�O�bYYif�'�'] � � )Q � O �� <br />LICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor's Agent _ Tenant (must P�vide a ietter ot consern rrom me owr,er co do wor� �n u,e SPa�> <br />ITRACTOR '(� Ke �s �n �.�ron rc�-h c� �n State �ic. #.T� IZr�dC G I(� I� City Bus. Lic. # <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />Phone/Emaii i/_!1 � <br />PRICE OF WORK <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 _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�-�" �� � ��_�,����.� <br />MECHANICAL PERMIT APPLICATION <br />ofProject: _New_Addn _Alteration_Repair <br />Show Number (#) of fiartures <br />A/C — air handlinq units <br />Gas <br />Gas fireplace <br />Gas ranae <br />Unit heater <br />Boiler <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />)emolition Change of Use <br />g <br />� r � ���' � Iii�eC ��1 <br />��c � �n I� <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number f#) of fixtures <br />basin <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Drinking Fountain <br />Floor drain <br />Grease trao <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 corzect. 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 pertnd does not presume to give aufhority to vioiate or cancel the provision of any other state o� local law reguiating consVuction <br />That I am authorized by the owner of this property to pertortn the work for which appiication is made and I compty with the State Contradors Law 18.27 RCW and 296.200A WAC. <br />�` 7-iy <br />Owner/Author ed Agent Signature Date <br />(Revised 3/2013) <br />�t <br />