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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 ADDRESS: / <br />��� L �ciL � )yC, %7 <br />LEGAL for new construction: Short PlaUsubd <br />� v�f�c }'f G <br />OWNER f�vi'� �-�ict IJtic��Fi'c_ <br />Address S(�n,K- c� S S' �-C: <br />APPLICANT: _ Owner _ Owner's Agent � Contractor <br />CONTRACTOR �jc���[;v�� b' [�•,i }�(�*���s/ <br />Address .S ��l �3 i� � i ( O� � �� �( ��t' �� <br />BUILDING PERMIT APPLICATION <br />PROPERTY TAX # <br /># <br />No. (attach copy of long legal description) <br />Phone/E-mail <br />City/State/Zip <br />Contractor�S A9@flf _ T@f1811f (must provide a lelter of consent from the owner to do work in the space) <br />State Lic. # City Bus. Lic. # <br />���n L�'%� �j��l Phone/Email ,�L.G �%3�/ ,j(�c;L) <br />CONTACT FOR PERMIT <br />��ln.' I r'/�� �'` C� �/IW _ C�'�/r7 <br />Phone/E-mail � ��? ; �i j�j �i lc � �, Z �f�j � <br />CONTRACT PRICE OF WORK <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />HEAT SOURCE: <br />Electric Othe <br />Demolition Chanqe of Use <br />i.r���,.� c' I � p(VrnYJi.�q f;X �vl`e 5 � ��`+�. —r 1 ct1� /.1.s {-<;ll L/ � /t.�/�,.. -�r�C �-�lE-s- <br />� � � <br />L� } � ��� � ,��� �. � � �. � �� ��t � ( Si'�`�ks i.� �: � ����� s� <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair Type of Project: _New _Addn �Alteration _Repair <br />Show Number (#) of fixtures Show Number (#) of fixtures <br />� A/C — air handling units i <br />Forced air systems ; <br />j Gas piping Z j <br />; Water heater � <br />Gas fireplace <br />j Gas range <br />i Clothes dryer <br />Range hood <br />i Exhaust fan � j <br />I Heat pump <br />Unit heater i <br />Boiler <br />rtetngerauon <br />Woodstove <br />Ductinq <br />SPRINKLER / SUPPRESSION SY <br />Number of Heads <br />Bathtub <br />h ba <br />Kitchen sink & dispo <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mo <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas G� <br />Other: <br />Other: <br />d�in <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 to 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 peRorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.2DOA WAC. <br />� <br />��� !z« �l�Z �3 <br />Owner/Aut rized Agent Signature Date (Revised 3/2013) <br />