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� � . <br />�ERMIT APPLICATIO� <br />, � <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ITE ADDRESS: � e�YY�-O)'� PROPERTYTAX# PERMIT / <br />�L'�.�_ L/� yT LI .r s �r3S/ 7/SS/D D/ D D CJ ��D �'�D D{e <br />GAL for new construction: Short PlaUsubdivision <br />�v �.e E7? ��fa o s- 17 <br />Address � 7�3U �' <br />APPLICANT: _ Owner <br />CONTRACTOR P.�Ce <br />Address 9� 9 ✓ . <br />TENANT BUSINESS NA <br />No <br />Phone/E-mail <br />Owner's Agent � Contractor }� Contractor's Agent <br />�1! <br />�V �,��T% /`f/�ri� JlC/fQDt <br />BJILDING PERMIT APPLICAT101� <br />(attach copy of long legal description) <br />�Y��� ���Q� <br />@Il2fll (must provide a letter of consent from the owner to do work in the space) <br />L& I Lic. # .�!/�7L��/� 77 COE Bus. Lic. # U y c <br />�5.3 - 5c�3 • 33a �s x iS� <br />� � Phone/Email <br />Sld can/i�i �.tr.»�.SieS•�• c.• <br />CONTACT FOR PERMIT <br />Cao it/iv �� �I ��� y <br />Phone/E-mail LyO�r/�j� (�y�Ltlry!/� /Gw/S •�C � <br />CONTRACT PRICE OF WORK g a. SD!� <br />Existing Use of Building �,//��,[ SG>hfGo.t_. HEAT SOURCE: <br />Proposed Use of Building �/�tf ��'hiDGL Gas_ Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family �L 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): /�,,�ST� �L. ,,VEw �/��,,L� Fjtc►� <br />-�C �t7 /»�SSAG � G'�u7 �.t oiu y--n� E Lc�E.ST s��.7� <br />O f= �� �fiGN ���oac .C4u� cD�iu� �l9c�NG- LcJ�T/»o�F. <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 fire�lace <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSI <br />Number of Heads <br />SYSTEM <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Add� _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & dfsposal' � <br />Dishwasher <br />Clothes washer <br />Water heater . _ <br />Backflow preventf <br />Urinal <br />Drinking Fountain <br />Floor drain <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 complied <br />with whelher specified herein or nol. 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 for which application is made and I comply with the State Contractors Law 18.27 RC1N and 296200A WAC. <br />� ��C� <br />��, J��E+�/S� <br />Owner/Authorized Agent Signatur Date (Revised 6/2012) <br />