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PERMIT APPLICATIOIV <br />BUILDING/IVIECHANICAL/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 />P�} � �E I ai u n, b�r �� �j C�S L�C�G' �Cs � cs <br />SITE ADDRESS: CVR,�y- f- PROPERTY TAX t# PERMIT # <br />� . / f �� ,- � �. � � .�, �- 1 . , G . _ „ _ , . � .,. r.�-,_-, ,., ,4, r / ) l 1� � S� — /Y1 � <br />LEGAL for new construction: Short PlaUsubdivision Lot No <br />ER ��.�r„�,,.--t- 1 :\, �. <br />idress LI � ( �'i � � �" � � �C �'� r�' 1 � <br />PPLICANT: �Owner _ Owner's Agent _ Contractor <br />�CTOR � �• <br />� ��aK ,.�-'� <br />r,�,SC, <br />mail <br />�City/State/Zip <br />Contractor's Agent _ <br />State Lic. # <br />(attach copy of long legal description) <br />C, _ -7�1- �-7 9� <br />ui �`<� c� , Lc���;.r��.�a�`�� <br />flf (musl provide a letter of consent from the owner to do work in lhe space) <br />Bus. �ic. # <br />IPhone/Email <br />CT FOR PERMIT . <br />/�' .�— T (�f C..� /1 �y ,s*, <br />�L, �i�,+�=� ��'lc �'�—� � � ��� 4� - <br />( VA'�� � (c ���'C.Z� \ l,�\�(1� 1 ��C�% 'isS< Phone�,E-mail .�J �-- � l �" <br />BUILDIN� F'ERMIT APPLICAYION CONTRACT PRICE OF WORK ��Z� � <br />Existing Use of Building �i1 �tif'%-� ��'t5�-- HEAT SOURCE: <br />Proposed Use of Building �� pi-f-t�-I `��ix �"�- Gas Electric �Other <br />Building type: v�Siryle Family _ Cuplex _Townhouse _ Mufti-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) :�.Q� C`' --�'�Y'�% �'� �` ��C� v�C� h��' C`'F �► �-J�."' z" S; <br />}-'',rt 1 S/` �iXt�«.�i�• <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />A/C - air handling units <br />� Forced air systems <br />i Gas piping <br />� Water heater <br />Gas fireplace <br />� Gas range <br />; Clothes dryer <br />Range hood <br />j Exhaust fan <br />� Heat pump <br />j Unit heater <br />; Boiler <br />Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />Lavatory (wash basi <br />Shower <br />Kitchen sink & dispc <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mc <br />Backflow qreventer <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 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 lo violate or cancel the provision of any other state or local law regulating construction <br />That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WF�C. <br />� <br />� � ` T /�. <br />=. - ��a� J �� <br />Own rlAu orized Agent Signature Date (Revised 3/2013) <br />