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� <br />CJ <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- 57-8857 www.everettwa.org <br />� �v"Ki ic L��-1- , t�c ' � �1��'a�tc'��c,� <br />TE ADDRESS: oonoroTv rnv H o�oee�r u <br />c� <br />3 2� r�-�!�� ������ �� F�X,,� <br />- %' `� <br />�AL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />'NER /�r,-t �� �c� /" �', " - �G( c,� : �'. Phone/E-mail �115 - L L _�>�. �'"� ct Y L�d C'� <<c (, l � M <br />ress (J i � �c = �f� - - .��,j City/State/Zip � v" = a" J � L_.� /� `i � �- C.\' � <br />�LICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor�5 A9ellt _ T81l8f1t (must provide a letter oi consent from the owner to do work in the space) <br />ONTRACTOR �% ��J /��j ��j�' <br />dress <br />State Lic. # <br />hone/Email <br />Citv Bus. Lic. # <br />� � <br />`/Z S —>`/�1 - scSZ <br />Phone/E-mail C( � ��� �s ��'tC`, �< <�C ��� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �fG:'C°� G <br />Existing Use of Building ���x-Y-r�ty✓e-T., '� HEAT SOURCE: <br />Proposed Use of Building��'�✓'�'vs�t r�n�� 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 dd / d d <br />(a itiona space prov� e on the back) . /- <br />��f ' ,�1 � _ / � 1� � (, c '.`� r V: �� �,7 t.�, r. _ �� �.. C!' ��F'� < <br />1 � J � y- <br />MECHANICAL PERMIT APPLICATION <br />Type 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 />� Water heater <br />j Gas fireplace <br />i Gas range <br />! Clothes dryer <br />Range hood <br />Exhaust fan <br />j Heat pump <br />; Unit heater <br />' Boiler <br />Woodstove <br />Ducting <br />j Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />, Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fiztures <br />j Toilet <br />i Bathtub <br />j Lavatory (wash basin) <br />� Shower <br />� Kitchen sink & disposal <br />; Dishwasher <br />i Clothes washer <br />; Water heater <br />Sink (service/bar/mop/etc.) <br />; Backflow preventer <br />Urinal <br />Drinking Fountain <br />j Floor drain <br />i Grease trap <br />Roof drains <br />� Medical Gas <br />� Other: <br />I 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 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 pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />//- � � ',�� <br />j /; <br />//�L-- ^ l � — � > .�i � _� <br />/ . � <br />� Owner/Authorized Agent S' natu/e Date (Revised 3/2013) <br />