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� � �^ <br />� � I ��? �l� �'�� <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 />SITE ADDRESS: r� � <br />��� � (1� <br />LEGAL for new construction: Short Plat/subdivision <br />�-� 1 �'�t��7 IPROZP.E <br />� C n <br />OWNER I iC C- ) � � ' _�� � ��� <br />Address� � ��j% ��=� <br />APPLICANT: _ Owner _ Owner's Agent �Contractor <br />CONTRACTOR <br />�V � <br />BUILDING PERMIT APPLICATION <br />Phone/E-mail <br />City/State/Zip <br />\X # /� PERMIT # <br />� ri'1'" l /(,�-X_._.�L'�T .f <br />No. (attach copy of long legal description) <br />� f���� J J�.�L; `� � v <br />�' , _.� ��- <br />r�' . a._ _� J L ;i l!/I /ii/7./� <br />Contractor'S Ag21lt _ TC'f18�i (must provide a letter of consent from the ovmer to do work in the <br />State Lic. #���/t('t7/ 1� /C���City Bus. Lic. # <br />/� ] r�=T �'� 9� i`�/� J� �f <br />i',� .�''�� �;; � �-" Phone/Email :__. �1�L�'��%�� .� ��� �/ <br />O[JTACT FOR PERMIT <br />�,�7 � <br />'�'(��,�),{"��';,� /7 �r`'Z> � `= ��'/\-. <br />Phone/Ehnail �� �' (' �'' 1 � <br />CONTRACT PRICE OF WORK ��(��L{':, �I�� <br />Existing Use of Building �..�f� �' HEAT SOURCE: <br />Proposed Use of Building ���F' � Gas Electric Other <br />Building type: � Single Family _ Duplex _Townhouse _ 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) : , <br />(,,n� r:;.c.�i 1�L� ��'.�fl,-{=> �-�.�r�:�-f ��e�-��� C:..���1, :'�� t.��r�i3l'i� {L�.����. <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />A/C — air handling units <br />Forced air systems <br />Gas pipin <br />Water heater <br />Gas fireplace <br />Gas ran e <br />Clothes dryer <br />Ran e hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refri eration <br />Woodstove <br />Ductin <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet / <br />Bathtub <br />Shower <br />Kitchen sink & d' posal <br />Dishwasher <br />Clothes w� er <br />Water 17,eater <br />Si kn�f�servicelbar/mop/e <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />ntain <br />I hereby certify that I have read and examined this applicalion and know the same to be true and correct. All provisions o( laws and ordinances governing this type of work will be comp <br />with whether specified herein or noL The granting of a permit does not presume to give authoriry to violate or cancel the provision of any other state or local law regulating construction <br />Th am thori e owner of this property to pe orm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />� <br />.� ! <br />i <br />�= �� '���,..,� f�� �'(��„ � �� , � � ��"-����� <br />O erlAuthorize Agent Signatur�e Date �(Revised 9/2014) <br />�� . �� � <br />