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• • <br />PERMIT APPLICATION � <br />BUILDIf�G/MECHANICAL./PLUMBING/SIGN/SPRINKLER/DE:MOLITI�N <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 />_ �17 k�,s��- <br />LEGAL for new construction: Short PlaUsubdi� <br />OWNER G��'Y� ,� G ( c:;l � �G� <br />Address <br />APPLICANT: _ Owrier _ Owner's Agent <br />CONTRACTOR {-*iti�� b S-1� c� h'tl�� <br />dress <br />;- <br />TAX it <br /># <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail <br />�� <br />ICity/State/Zip <br />Contractor _ Contractor�5 A jefl� _ T8f18�1 (must provide a�letter of consent irom the owner lo do work in the space) <br />� -� �/� State Lic. # City Bus. Lic. # <br />Phone/Eipail �'' � `� �-1�-��'% � � <br />BUILDING PEI�MIT APPLICATION ,� <br />Existing Use of Building `) i(r�9L P �'� J�'I r�� <br />Proposed Use of uilding ` ,�. /L �: <br />Building type: �Single Family _ Duplex _Townhous <br />Type of project: New Addition :� Remodel e ir <br />DES RI�TION OF WORK (additio al space provid on the back) : <br />. � �'�,i�� d�i����5 �.✓i� t�:��� � hy <br />, ly.�l <br />6ec,�v'�6Y"�5,; r�fc�zc� r,�,Xr' <br />p^�-�Lc��C' ^r l� l5'f'l �I <- _5 t✓� 1 �� <br />MECHANI�CAL PERMIT AP ICA <br />Type of Project: _New _Addn _Alteratiorr'� air <br />Show �/umber (#) of ixtures <br />A/C - air h dling units <br />Fp2�d�air svs s <br />SPRIN <br />heater <br />eplaCe <br />Clothes dryE <br />Range hood <br />Exhaust fan <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />Other <br />IR / SUPPRESSION SYSTEM <br />Number of Heads <br />CONTACT FOR PEfTMIT <br />1 �,n--,r;�'�,.r� - 8��,(.�; �„L s; ;r'�%, <br />Phg�elE-mail <br />CONTRACT P ICE OF WORK }J�O� <br />f <br />� HEAT SOURCE: <br />__ G,' l Gas Electric �� Other <br />Iti-F miT� _ Commercial <br />T.I _ Sign _Sprinkler Demolition Ch�ange of Use <br />� <br />� > ���^ �`' � � SS� � 6 �=�C � r f'o �.c�� ��� b <br />�- � � � s �,(� �� �1� f � �°<< � r� ���'���-i�� � ��,;;� <br />V' � � � �� << f��.{� �vk,' �V � 't-c; , <br />/ n , ,{� � <br />l 'f /� �,v'i CC 'y' �C ' ���:� t�,� 11 5 ��'� ( •r � . 1 �`- � r� �tLi r \ 1.� `JTn � �' S <br />PLUMBING PERMIT APP'LICATION <br />Type of Project�-1 ew _Addn Alteration ,�[Repair <br />Toilet <br />Bathtub <br />SholNer <br />Kitchen sink & di; <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/ <br />Backflow prevent� <br />Urinal <br />Drinkina 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 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 authority to violate or cancel the provision of any other state or local I�iw regulating construction <br />That I am authorized by the owner of this property to eertorm the work for which appiication is made and I comply with lhe State Contractors Law 18.27 RCW and 296.200A WAC. � <br />� � 2 <br />� � — ___ <br />�j'� ' �� � �3,�r`Y <br />!/ /G <br />Owner/Authorized Agent Signature Date (Revised 3/2013) <br />