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• � <br />PERMIT APPLICATION <br />BUILDINGIMECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETf PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />ADDRESS: <br />LEGAL for new construction: Short PlaUsubdivision <br />eR IM r rlrJ ;n,l ' <br />ss `���� �1 fo�1 � <br />.ICANT:'� Owner �� <br />� <br />TAX # <br /># <br />Lot No. (attach copy of long legal description) <br />� <br />Owner's Agent _ Contractor _ Contractor�S A9@fll _ T2f18�I (musl provlde a lelter of consent from ihe owner io do �wrk in Ihe space) <br />r <br />Lic. # <br />Phone/Email <br />Bus. Lic. # <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building ' HEAT SOURCE: <br />Proposed Use of Building '��" Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commerciai <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) : <br />V�v� C t`� ��.�� <br />� � <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Forced air s stems <br />Gas ioing <br />Water heater <br />Gas fireplace <br />Gas range <br />� Clothes dryer <br />Ran e hood <br />Exhaust fan <br />Heat um <br />Unit heater <br />Boiler <br />W oodstove <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 fiztures <br />; Toilet <br />Bathtub <br />j Lavatory (wash basin) <br />Shower <br />I Kitchen sink & disposal <br />Clothes washer <br />Water heater <br />Sink (service/bar/i <br />Backflow preventE <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 goveming this type of work will be comp <br />with whether specified herein or not. The granling of a permit does not presume to give aulhority to violate or cancel the provision of any other state or local law regulating constructan <br />Tha[ I am authorized by the owner of this properly to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />� ` Ji <br />wnerl horized Agent Signatur Date (Revised 9/2014) <br />`Cilz'�. <br />