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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 />SS: <br />LEGAL for new construction: ShoR PlaUsubdivision, <br />owNER J���2rn,��� � /�tr?f? <br />Address i� ry ,� � /,1=�/ /nG'���' ��� <br />PROPERTY TAX ii <br />PERMIT # <br />Lot No. (attach copy of long legal description) <br />�,.-!� ~+ / �� <br />Phone/E-maii�r c:-�� J �� �� �'f �`� � /7�� ;-- . ,�� ,/ <br />City/State/Zip���r� �j�� �,lG'�f <br />APPLICANT: ✓ Owner _ Owner's Agent _ Contractor _ Contractor'S A9Bflt _ T0118f11 (must provide a lelter of consent from the owner to do wor{c in the space) <br />CONTRACTOR <br />ress <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 <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family <br />Type of project: New _ Addition Remodel _ Repair � T.I. _ <br />DESCRIPTION OF WORK (additiona/ space provided on the back) : <br />��{1^ 0 J E-- S � � e--�i GG l� T�'G rt� JC1,�•'/u -L� h�' <br />MECHANICAL PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />I Forced air systems <br />j Gas piping <br />i Water heater <br />Gas fireplace <br />� Gas range <br />Clothes dryer <br />Range hood <br />j Exhaust fan <br />j Heat pump <br />; Unit heater <br />� Boiler <br />' Woodstove <br />Ducting <br />i Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Citv Bus. Lic. # <br />HEAT SOURCE: <br />Gas Electric ;n/ <br />Commercial <br />Sprinkler Demolition Change of Use <br />PLUMBING PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />� Bathtub <br />i Lavatorv (wash basinl <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/e <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby ceRify 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 authorized by the owner of this property to perform the work for which application is made and I comply with the Slate Contractors Law 18.27 RCW and 296.200A WAC. <br />�� � � --- <br />G <br />�Owner/ ut o ze ent Sig Date (Revised 3/2013) <br />