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� <br />PERfVIIT �4PPLICATIOiV <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 />SITE ADDRESS: <br />�iflo33 ' <br />PROPERTY TAX # <br />PE <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />ER <br />PhonelE-mail �� <br />� <br />idress i.��o'3�3 5�1 v�✓'-E-�,� l.t.�v-� ICity/State/Zip �--�-����� �k-.� �-yt�1�3 <br />PPLICANT: _ Owner _ Owner's Agent � COf1ff2Cf0� _ COIlffBCfOf�S AgOflf _ T011Bf1t (must provide a letter of consent from the owne� lo do work In the space) <br />TOR <br />ress � <br />BUILDING PERMIT APPLICATION <br />State Lic. # FVCi,� �= <br />�+` Phone/Email <br />CONTACT FOR PERMIT <br />Phone/E-mail <br />�yl.�l(��i City Bus. Lic. # <br />-� Z S- 3_ � U— SZI (o <br />CONTRACT PRICE OF WORK <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas_ Electric Other <br />Building type: _ Sirgle Family _ Duplex _Tov�mhouse _ 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) :'-�� 'TJ �Q ���,��-►.l�C� �"1 �,Zt[�-� <br />��-�c� St --�� .�r� �r� ���� 1 �,�. ��. ' �*-� � <br />cz� r c� t� � <br />� �� � � �/ ✓ '� C� � i�C t��� � � Y'�%�, , U E�i <br />� L � � ( s'4 c�.. <br />�/vc-� c? j IJ vJ� Tii ���_ Ci �*PM _.__ I C5�5 � �" �` � <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 />j Gas range <br />Clothes dryer <br />Range hood <br />� Exhaust fan <br />� Heat pump <br />i Unit heater <br />' Boiler <br />; Refrigeration <br />Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRE <br />Number of Heads <br />ON SYSTEM <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />� Bathtub <br />� Lavatory (wash basin) <br />j Shower <br />i Kitchen sink & disposal <br />i Dishwasher <br />; Clothes washer <br />i Water heater <br />� Sink (service/bar/mop/etc.) <br />I Backflow preventer <br />i Urinal <br />Drinking Fountain <br />j Floor drain <br />; Grease trap <br />� Roof drains <br />I Medical Gas <br />I Other: <br />� Other: <br />I hereby certi(y 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 ihe provision of any other state or local law regulating wnstruction <br />Th am authorized by the owner of this property to periorm the work for which application is made and I comply with the State Contractors Law 18 27 RCW and 2962DOA WAC. <br />i <br />� C� I �'i <br />Owner/Authorized A nt gnature Date (Revised 3/2013) <br />