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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 />:�t I - 4� <br />EGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />. / ( n /�.../ <br />OWNER / �' , <br />Address , ����/ j , �i <br />APPLICANT: wner _ Owner's Agent Contra tc <br />CONTRACTOR � �I � �X <br />Address <br />TENANT BUSINESS NAME <br />f� -����y <br />/\ <br />BUILDING PERMIT APPLICATIOI�I <br />Existing Use of Building ''�� • � _ <br />Phone/E-mail <br />f_ COf1lf8CfOf�S /�g2f11 _ TBfl2flt (must provida a �etler of consent from Ihe ownef to do work in the space) <br />State Lic. # <br />Phone/Email <br />hone/E-mail <br />ONTRACT PRICE OF WORK <br />Bus. Lic. # <br />HEAT SOURCE: <br />Proposed Use of Buildin l C � `-� � Gas Electric_ other_ <br />Building type: _ Single Family _ plex _Townhouse � Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DESCRI TION OF ORK (additional ce pr vided on the back) :., <br />� <br />.I �l� ��l�ti�c� s�i���� ��c �����>r'� J��; l''���-� ��,y� <br />��� � <br />� � , �.% <br />� ,� , _ <br />> � �- , � <br />MECHANI AL PERMIT APP CATION <br />pe of Project: _New _Addn _Alteration �f2epair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />I Forced air svstems <br />S <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />� Unit heater <br />; Boiler <br />; Refrigeration <br />Woodstove <br />Ducting <br />�� Other <br />KLER / SUP E SION S <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteretion _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />� Bathtub <br />� Lavatory (wash basin) <br />j Shower <br />j Kitchen sink & disposal <br />j Dishwasher <br />� Clothes washer <br />; Water heater <br />� Sink (service/bar/mop/etc.) <br />I Backflow preventer <br />unnai <br />Drinking Fou <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby ceRi(y 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 />wilh 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 law regulating construction <br />That I am authorized by the owner oi this property to pertorm the work for which applicalion is made and I comply with the State Contractors Law 18 27 RCW and 296.200A WAC. �� � <br />i <br />� --_ __ _--- � <br />,; --- _ � � ��� <br />neT)i�vtt`i rized Agent Signature Date (Revised 3/2013) <br />