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• • <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />C{TY OF EVERETT PERMIT SERVECES <br />3200 Cedar St., Everett, WA 982d1 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />��C�_AC_ <br />� <br />TAX # <br />�i S(_"�C: �`- l C+ i G�-� <br />LEGAL for new construction- Short PlaUsubdivision Lo <br />OWNER �'� � � �Slc'/"r1 ���''`� -S Phone/E-mal <br />Address � �I i/�� �LE �'� �� �f'�c_ j�-1 j'� City/S4ateiZ{ <br />APPUCANT: Owner _ Owne�'s Agent _ Contractor _ Contractor's Agent <br />CONTRACTOR 4'� tL rr� �sL�-m � u� �( <br />r; f,�� f 1 � i�� � State Lic. # <br />��C!.�'2 �� FY'�Yl S c> >-f �- u <br />� <br />No. (attach copy of long iegal description) <br />�s- ,3� �--���� <br />�, �-� �--r � " . 1, ;A� c:ik�C. . <br />T2[78f1t (must provide a letter of consent from the aNner to do worh in the space) <br />�Pnone/Emaii � — <br />ACT FOR PERMIT <br />BUILDING PERMiT APPLICATION CONTRACT PRICE OF WORK � <br />Existing Use of Building `'� �� � � t� l y HEAT <br />Proposed Use �f Buiiding Gas Eb <br />Lic. # <br />(�G <br />Buiiding type: _ Singie Family _ Dupiex _Townhouse _ Muiti-Family _ Commercial <br />Type of project: New Addition Remodef Repair T.I. Siqn Sprinkler Demolition Chan e of Use <br />DESCRIPTI�N OF WORK (additiona� space �rovided an the.bac� : — - .,_/�.�� � _ ,- ,,�( �r�� <br />��1 f�'VL� C�--t ,� J C� S'''�'� �.. �%C': t°I C� 1\a f �il: � C 1.:� ri 7 c. 5/ �. �If��F � `(� l l i Y: ��- S� <br />i <br />�� �..5�� u7�'1 S; C i�' J. <br />MECHANICAL PERMIT APPLICATION <br />Type 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 />E�chaust fan <br />Heat pump <br />Un+t heater <br />Bo6Eer <br />Woodsteve <br />Other <br />R / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Shoor Number (#) of fixtures <br />Toiiet <br />Sathtub <br />Lavatory (wash basin) <br />Shaurer <br />Kitchen sink & disposa! <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (servics/bar/mop/etc.} <br />Backflovu preventer (insitle bldg <br />Urinai <br />Dr�nkirag Fountain <br />�(oor drain <br />Grease trap <br />Roaf drains <br />Medical Gas <br />Other: <br />Other: <br />I hEreby certrfy that I have read and examined thfs application and know the same to be true and correct. All provisions of laws antl ordinances governing this type of work will be comp <br />wah whether specified herein or not. The granting of a permif does not presume to give authoriry to violate or cancel the provision of any other state or local law regulating construction <br />That I am authonzed by the ovmes of this property to perform the work for which a lication is made and I comply wifh the State Contractors Law 1827 RCW and 296200A WAC. � <br />= � � � �,,�� - � � <br />�,ti _ 1,,. <br />OwnerlAuthorized Agent 5ignature Date (Revised 4/2015) <br />