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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 />SITE ADDR SS: PROPERTY TAX # <br />t � 2'� C� E�'1"�•1 U T ST <br />LEGAL for new construction: Short Plat/subdivision Lot No. � <br />PPLICANT: _ Owner _ Owner's Agent <br />ONTRACTOR � (� Ke �s � �.�r <br />Phone/E-mail <br />PERMIT � <br />i�C�� - <br />(attach copy of long legal description) <br />ICity/State2ip 5�O!'�CSYYlL �i In �)Q � O d-1 �D <br />Contractor _ Contractor's Agent _ Tenant (m�� P�ov�de a ietter a consenc rro�r� v�e owner co do worx �n u,e 5pa�� <br />Lic. # <br />0 <br />Bus. Lic. # <br />�f <br />BUILDING PERMIT APPLICATION <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 />HEAT SOURCE: <br />Type of project: _ New Addition Remodel Repair _ T.I. _ Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : � j� r �l � �� � .� `�fVl.� F <br />� <br />--t,.,�,;� � � ��., � :.�,� i �,��� -�� ��`����.�, E3 [<.�c <br />� <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repalr <br />Show Number (#) of fxtuies <br />A/C — air handling units <br />I Forced air systems <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 />( Other <br />SPRINKLER / SUPPRESS <br />Number of Heads <br />of Project: _New _Addn _Alteration _Repair <br />Show Numbei (#) of fixfures <br />I Toilet <br />Kitchen sink & <br />Fountain <br />r <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 type of work will be complied <br />wtth whether spec�ed herein or not. The granting of a permit dces not presume to give authority to violate or cancel the provision of any other state or locai law regulating consWction <br />That I am authorized by the owner of this property to perform the work for which application (s made and I compiy with the State Contractors Law 18.27 RC W and 296.200A WAC. <br />7 <br />���- � 7-�y <br />Owner/Authorized Agent Signature Date (Revised 3/2013) <br />