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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 />V,fi � 3! 1 � D� <br />AD �' � � / / lY JL�I.��L'CK / /Ai�C�-� PRVP�� t "I � ( �IO ( `� �C/ �O �_ P�Mw#1 �6 I ' � � � <br />L for new construction: ShoR PlaUsubdivisio <br />�WNER ��'i L-.( i{�%Y� <br />�dress '��� ,����� <br />PPLICANT: _ Owner <br />ONTRACTOR /�- <br />�dress <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail <br />�i � K �.'��/ I 7 /`l�.i��� r �C.C-�...1 <br />� ,� City/State/Zip ��,) � � � , <br />Owner's Agent _ Contractor _ Contractor�5 A92flt _ TBflBfli (must provide a letter of consenl from the owner to do work in the space) <br />BUILDING PERMIT APPLICATION <br />State Lic. # <br />Phone/Email <br />Phone/E-mail <br />CONTRACT PRICE OF WORK <br />Existing Use of Building <br />Proposed Use of Building Gas. <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler _De <br />DESCRIPTION OF WORK (additional s ace provided on the back) : <br />�5t.c�.'L{.'1'�,� C�13'L�.'}-� �L�`�-�l!✓1,V ��i�� l�-'��`' �� <br />'� � � � <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixiures <br />i A/C — air handling units <br />i Forced air systems <br />i Gas piping <br />i Water heater <br />j Gas fireplace <br />j 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 />Citv Bus. Lic. # <br />HEAT SOURCE: <br />Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />h <br />Kitchen sink & d <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/ba <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />r <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 />with 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 auth�pd b the owner of lhis pro erty 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 />�--- i(, � - - <br />Owner/Author' ed gent Signature � Date (Revised 3/2013) <br />