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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: PROPERTY TAX # PE�M IT # <br />181� �l f,ce.��� �N�-. f(� G°:,� — ��.�J'F" <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER�p ,tr o��p� Phone/E-mail f.�2 D 5 ��/ u1G� <br />Address � �, M,t '�G. 2pp City/State/Zip �{/C/' � 2 8�P <br />APPLICANT: _ Owner _ Owner's Agent �Contractor _ Contractor'S A9Bflt _ T8f19�t (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR �dl.�+�+Q.�j (�Hrl�l-Q/�N L& I Lic. #�il��„v��0 M� COE Bus. Lic. #c�$100; <br />Address �028 �� Stiz��, �.iQ�C�qy��� , Wp� Q$o33 Phone/Email d{L�-f�22-22'y� �,0��`"7 ���`� <br />�I�.��► ��x s�r �it� Fy� C.r'�sT� <br />BUILDING PERMIT APPLICATION <br />CONTACT FOR PERMIT�� S�AF:2� <br />Phone/E-mail(�(pp, 34"j'��( (,�yLS Q170�,y��JPJC� <br />CONTRACT PRICE OF WORK � ,`� � ���2. .QO <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas Electric Other <br />Building type: _ Single Family _ Dupiex _Townhouse _ Multi-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) :�,��_ .��`� �d MES}�L �a� (,a�rt.j-(r rr�Tn'3 <br />ca•�rt,� n�.� p� P►�,�/ w��`r,�s. (/�o �e�c i�s� � z�4�v� 9 A�pa�vnc.til-s� _(�P� <br />(,Q.�n � ti' i S�D��-trn. �1Gtl.J � � d�,� ��O��j '�,�� . <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Type of Project: _New _Addn _Alteration �Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <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 <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 />wRh 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� r this property to perform the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. <br />.�—�� <br />2-12-?r�� <br />Owner/A oriz gent Signature Date (Revised 6/2012) <br />� <br />