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' • • <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />���200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />6 <br />ADDRESS: / PROPERTYTAX# t'•""/i 7-�'%��i�2 iQ�B.�1Al <br />� �cfc�: f-i�� %�V� no'�7i7'� 72�•��izcf K���L'(�� <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER /'"� fG �' r� ���! �� -' �GG� Phone/E-mail `fZ`� <<�c� - n-�.� � <br />Address/7G� ��c>X � ?� �(�� City/State/Zip ��✓t'i��� L1//� �%��� �1.=�,� <br />Owner _ Owner's Agent <br />CONTRACTOR <br />dress <br />Contractor _ Contractor�S A98flt _ T2f10f1t (must provide a letter of consent from the owner to do work in the <br />ii <br />� <.-r G�,fi ✓ G� / �/ ✓'� <br />: <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ <br />Type of project: New Addition Remodel Repair <br />DESCRIPTION OF WORK (additiona/ space provided on the back) <br />����j �-'�1C�S <br />/ �I <br />C►r�i���[ b�.r,� l�o��- <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C - air handlin units <br />Forced air s stems <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes d er <br />Ran e hood <br />Exhaustfan <br />Heat um <br />Unit heater <br />Boiler <br />Refri eration <br />Woodstove <br />Ductin <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />State Lic. # Citv Bus. Lic. # <br />Phone/Email <br />�vrv i r��, i rvr� rcrcini�i,,j ,(lca�o N�/".✓� /`"c�:t�/e� Y' <br />,�Kj�7 f��'Gh. /�'�/tiY't- id/�5�25Z'-?�S?i <br />'hone/E-mail C'�ti�i�/�z ` 7" 2G r.r�, u r'�- , e <br />CONTRACT PRICE OF WORK ���-' �-'�%�-� <br />, <br />HEAT SOURCE: <br />Gas Electric Othf <br />Multi-Family _ Commercial <br />�� T.I. _ Sign _Sprinkler Demolition Change <br />� — — <br />� SU' � s� rr �Te,� �;.��` <br />/`t7� i�G' +�P f1iJ e' :-� � �d T (fc f� /• V C <br />of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />Toilet <br />Bathtub <br />Lavato wash basin <br />Shower <br />Kitchen sink & dis osal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink service/bar/mo /etc. <br />Backflow reventer <br />Urinal <br />Drinkin Fountain <br />Floor drain <br />Grease tra <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 comp <br />with whether specifed 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 perform the work forwhich applicalion is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br />\��/(:/ L % 'L�i/:�/-`J I��.. /�,t ��� / %� /' � <br />% <br />Owner/Authorized Agent Signat re ate (Revised 9/2014) <br />