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0 <br />� <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 />SITEADDRESS:, PROPERTYTAX�1 >L' � '� _'�u� /� <br />� � � /� `i ' _� % - '1. PERMIT # � - Ull,� <br />�'�% , '� /�`�� ��t ��- � �� /i'��C'✓ �''c; / 5 ,�_? 7:'_ �`�� i�> �:� / � �.��1, <br />LEGAL for new construction: Short PlaUsubdivision <br />� <br />owNER o �f �r �` �� ��' �'���, <r <�� � � <br />Address %'� � �� �'�}( �� � (y J <br />�_. <br />APPLICANT: _ Owner ,� Owner's Agent _ <br />CONTRACTOR , 'v�, � Q � /�f <br />Lot No. (attach copy of long legal description) <br />� " - G. S `-L �,( <br />Phone/E-mail �l�a-� � ���� / <br />City/State/Zip �� l' �. I' �� /l. � `�� :� �- � <br />Contractor _ Contractor�S A9efli _ T@fl8flt (must provide a letter of consent from the owner to do vrork in the space) <br />�'� � � �- � =r l/�� i .� . , r , � _, � ?` ;, ,�` <br />Lic. # <br />BUs. ���. # 5 a <br />Phone/Email <br />CONTACT FOR PERMIT ;� �,,; -, � ; � �- .� i /c� ,- <br />% _ _ '._ � ._, _.- ,.� : �/..� i4�':.�/%� , �-e'-G_ f7q,�-� <br />Phone/E-mail ,��r�-�, c�:%�� -' ��`�/Z y�^�./�,f�G�r-rr�• �� .-,.-, <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ���, 00� <br />Existing Use of Building G' f-' 't�� <br />Proposed Use of Building T�e, :� r,� /-� f�i �--� <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family iC Commercial <br />Type of project: New Addition Remodel Repair � T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK ' <br />HEAT SOURCE: <br />�� Electric Other <br />Demolition Chanae o <br />(additional space prowded on the back) . <br />/, �,� � <br />�.�='- ~ _ %�E' � r ��% % c' �P � C� J o , � i <br />G����i%�: -;/�,-. 5����� <br />� � � t V I' � +�-+ �-/ <br />MECHANICAL PERMIT APPLICATION PLUMBING 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 />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <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 application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br />/: I� ' _'/ 1��� /' -i:' � �-",= ��-G 'i `�� i <br />�� � <br />Owner/Authorized Agent Signature Date (Revised 9/2014) � Z <br />