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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 />ADOR SS: PROPERTY TAX # PERMIT # ., <br />� 2 Cl-1 E 5'1"�1 U T ST r'_ i� f� 4- C� <br />1L for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />ER �n� n-�i � 1 1 C_ Phone/E-mail Z�� �',1�7[� ��11 L.�i '4.mr�,� v� ���i �w.��� <br />_ Owner _ Owner's Agent _ Contractor _ Contractor's Agent _ Tenant (must provide a ietter a wnsent rrom �ne owner �o do wonc �n u,e space� <br />�R .1G Ke �S `D Goroh ro►.-h c� r� state �ic. #.Tri 1Z�SdC G I 1°� 1� c�tv Bus. u�. # <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building � <br />Proposed Use of Building <br />Buiiding type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New _ Addition Remodel Repair _ T.I. _ Sign _Sprinkle <br />DESCRIPTION OF WORK (additional space provided on the back): <br />� / <br />� \ __._. <br />� � � u i � �i r�� --%�? )%�iL �v3 <br />t <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Gas piping <br />Water heater <br />Gas <br />Unit heater <br />Boiler <br />Woodstove <br />Other <br />ISUPPRESS <br />Number of Heads <br />HEAT SOURCE; <br />r Demolition Change of Use <br />1 c�r '�,�.c�� ��i,�rv�1� � <br />a<<.� <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Numbe� (#) of fixtures <br />Bathtub <br />Kitchen sink & d <br />Water heater <br />Sink (service/bar/ <br />Backflow preventi <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Medical Gas <br />Other: <br />Other: <br />I hereby certrfy that I have read and examined this application and know the same to be true and correct. Ail provisions of laws and ordinances goveming this type of work will be complied <br />with whether specfied herein or not. The granting of a permit dces not presume to give authority to violate or cancei the provision of any other state or local law reguiating construction <br />That I am authorized by the owner of this property to pertortn the work for which application is made and 1 compty with the State Contradors Law 18.27 RCW and 296.200A WAC. <br />� <br />�� � �- iy <br />Owner/Authorized Agent Signature Date (Revised 3/2013) <br />rn <br />r�+ <br />