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• • <br />�'ERMIT APPLICATIOIV <br />BUILDI�l�/IUIIE�F�A�lICAL 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 />��-02 5E �J�T�f �l-�U. U7� <br />LEGAL for new construction: Short PlaUsubdivision <br />OWNER $vj'��{D U��VC� 11J���'j -TOCz�C� <br />Address 5�'�O W�� F��A.-��' �VQ. )�71 r- i,�'7 <br />TAX q <br />PERMIT� <br />� � C` �, - <br />No. (attach copy of long Ieg�I descripti <br />Phone/E-mail 9�jZ Cj�}'0.�� <br />City/State/Zip <br />M�I , <br />PPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor�S A92fll _ TEllBflt (must provide a letter of consent from the owner to do work in iha space) <br />CTOR �C- �• � <br />����b ��� �t�S <br />BUILDING PERMIT APPLICATION <br />State Lic. # <br />Bus. Lic. # <br />I Phone/Email <br />NTACT FOR PERMIT Qo�� ���-Z.. <br />Phone/E-mail �71 <br />CONTRACT PRICE OF WORK <br />Existing Use of Building %t�W1W1,�Gl-� ^�w HEAT SOURCE: <br />Proposed Use of Building r�6�tlV`(V�,'�.Gf A'L ����� Gas� Electric <br />Building type: T Single Family _ Duplex _Townhouse _ Multi-Family �Commercial <br />Type of project: New Addition Remodei Repair � T.I. _ Sign _Sprinkler Demolition Chang� <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />Other <br />of Use <br />'�t�1�'r lY►1(I��t1E��'- Go�`�GT t�� �3��'�'e.o (s�1ViP l�►�� �s�' �,�G��'; �M� <br />-��(AL�C(' S�a�• �t�S'��� ad�l.l.. I`��C� �R.M.�S, �i�iJ�S� �,vtnAf3l'l`�� �'����5 <br />�*�- ��T�3�D 1�1�5 �=oR- x� GdY�I�G�.�C.-�tt �-5T/4c� P��rf' <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handlina units <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 />Refrigeration <br />Woodstove <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� �j <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink �sal m � <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: (,a�o�{ �� ,r <br />Other. w��vUUll S <br />I hereby certify that I have read and examined this application and know the same to be true and correct. Ail provisions of laws and ordinances governing this type of work will be complied <br />with whether specified herein or not. The granling of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I am authorized by the owne of this propeRy to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />J� 'v�"l5 l�Z <br />OwnerlAuthorized Agent Si Date (Revised 3/2013) <br />