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� <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 />.--�� D W/�G� F�C. /-I ►�F_ nl c-t E- ; <br />=GAL for new construction: Short PlaVsubdivision <br />WNER P� /v�' f � <br />jdress ) 3 Z 1 Dy �/ <br />PPLICANT: _ Owner _ Owner's Agent _ Contractor <br />CONTRACTOR �%/Q� 1'� <br />Address 34�J(p �'Ji1 <br />BUILDING PERMIT APPLICATION <br />Rnr Tax # <br /># <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail q�✓. 2(G l, 7 S✓ � <br />City/State/Zip �j���'�' � / ��� <br />Contractor�S AgBfl( _ T2flalli (must provide a letter of consent from the owner to do work in ihe space) <br />�,(,(G�� State Lic. # City Bus. Lic. # <br />� ,f.�/�Il g�j�p Phone/Email �(po. 73� 36� <br />CONTACT FOR PERMIT � n �� ��N�.�� <br />i �� � <br />Phone/E-mail „� h ih n a a�bn �• � <br />CONTRACT PRICE OF WORK Z� DOC7 <br />Existing Use of Building /u%FiQ/G/.��- Cif� HEAT SOURCE: <br />Proposed Use of Building Gas <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family �i Commercial <br />Type of project New Addition Remodel Repair T.I. Si n Sprinkler Demol <br />DESCRIPTION GF WORK (additional space provided on the back) : <br />I�i op�Fy D��'�e� .�� - I�M/�1-n/ �esac%e�'s <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn Alteration _Repair <br />Show Number (#) of fintures <br />� A/C - air handlin units <br />Forced air systems <br />I Gas piping <br />j Water heater <br />� Gas fireplace <br />� Gas range <br />; Clothes dryer <br />Range hood <br />I Exhaust fan <br />Heat pump <br />� Unit heater <br />� Boiler <br />I Refrigeration <br />' Woodstove <br />Ductin <br />.D i Other �' Gk <br />SPRINKLER / SUPPRESSION SYSTEM <br />I Number of Heads <br />Other <br />Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />� Bathtub <br />I Lavatorv (wash basin) <br />Shower <br />Kitchen sink & dis <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/i <br />Backflow preventE <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Roof drains <br />Medical Gas <br />Other: <br />I hereby cert'rfy 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 compl <br />with whether specified herein or nol. The granting of a permit does not presume to give authority to violafe 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 1827 RCW and 296200A WAC. <br />< � ' � - % .22�,�%� <br />��Autho ized gent� natu Date (Revised 9/2014) <br />