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� � �; <br />�, � I�� fl�,��r7 <br />� <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 ADDRESS: ,r � , �" <br />��%1 l� i� 1� ���J ��..��.�> <br />LEGAL for new construction: Short Plat/subdivision <br />OWNER I �LL ) � � _ .� ,� <br />Address.� � ��� c�.� <br />APPLICANT: _ Owner _ Owner's Agent �Contractor <br />CONTRACTOR � �� 7 � <br />Address ��L (,i I �i�, ��,�°✓, i-�,� <br />BUILDING PERMIT APPLICATION <br />RTY TAX # <br />PERMIT # <br />Lot No. (attach copy of long legal description) <br />� ��� <br />Phone/E-mail �� '� � J� -� � � `'�� <br />Ciry/State/Zip � � �� ��j ��� � <br />COIltfBCtOf�S /�92f1t _ T011811t (must provide a letler of consent from the owner to do work in Ihe space) <br />State Lic. # L!'f1CK('f 1/�r/'/`/1> / City Bus. Lic. # <br />i � f.7��� JI�P <br />� ���� i�' Phone/Email ������7•��1 '�� � <br />G�' O[JTACT FOR PERMIT <br />'��-��i.apt'C>'�.�' �'�'1�t_.�t`=��-- J� <br />Phone/E=niail �Y��i��' _(' �(m j��./�f �Y7✓l <br />CONTRACT PRICE OF WORK ` �'1�(��'-/", �! �� <br />Existing Use of Building ��' �--� HEAT SOURCE: <br />C / <br />Proposed Use of Building �� r Gas Electric Other <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <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�: , / <br />�'"��;. "�c°� l � G��� ��Ilt=:�=� �-�°rt�" f � 2�'9'.',� C'.� � y�'%3 �l� f,/'z�fl ��"i'' ��' ��` �. <br />/1� - <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixYures <br />A/C — air handling units <br />Forced air s stems <br />Gas pipin <br />Water heater <br />Gas fireplace <br />Gas ran e <br />Clothes dryer <br />Ran e hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refri eration <br />Woodstove <br />Ductin <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 />� Toilet <br />Bathtub <br />Shower <br />Kitchen sink & d' <br />Dishwasher <br />Clothes w er <br />Water Itieater <br />Sink .�service/bar/ <br />B flow preventE <br />rinal <br />Drinking Fountain <br />Floor drain <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 Ihe same to be true and correct. All provisions of laws and ordinances governing this type of work will be comp <br />with whether specifed herein or noL The granting of a permit does not presume to give aulhoriry to violate or cancel the provision of any other stale or local law regulating construction <br />Th am thori e owner of this property ro p25(orm the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. <br />.� �� _ �, ^ / ' \ ` � <br />1 ^ ,� <br />.` .� '; � ���`� � Il � ' � �����-�`� <br />O er/Authorize Agent Signatur� Date �(Revised 9/2014) <br />�' �� . �� � <br />