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• <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: PROPERTY TAX q P RMIT # <br />2�Zd I 9� s-T ��s� tec� 1 go� �� i�-1 r: �-I -�)C� � <br />for new construction: Short PlaUsubdivi <br />� , t _ �, <br />_ Owner JC Owner s Agent <br />�� <br />No. (attach copy of long legal description) <br />Phone/E-mail <br />City/State/Zip <br />COf1tf2CiOf _ COf1if8CtOf S f�9eflt _ TeflBflt (must provide a letter of consent from Ihe owner to do work in the space) <br />L& I Lic. # �',3( COE Bus. Lic. #"� <br />� `�,.E�G� Phone/Email ����i�i ��i/.,� / <br />Phone/E-mail N7 � �- <br />�F�F C?I�t.uu,��, F,� � <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building �(�„ HEAT SOURCE: <br />Proposed Use of Building S�� 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 />�i� ��� f�(#t-k• `� ��F �Mw� -� �wce�f- � ��. � ��M�fLSy <br />IU�� �-ifi� I i� SUL. � v�+J9't�� -- J�L4�s�.�"�Q�J ��i5� C?�[[-[�C� - <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />A/C — air handling units <br />Forced air systems <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes d� <br />ng�-Kood <br />aust fan <br />�-- <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />i Other <br />SPRINKLER I SUPPRESS <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Bathtub <br />basin <br />Kitchen sink & disp <br />Dishwasher <br />Clothes washer <br />Water heater <br />5ink (service/bar/m <br />Backflow preventer <br />Urinal <br />Drinkinq Fountain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined lhis application and know the same lo 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 m authorized by the o this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />' _ � � �/� <br />R � . <br />Ow nt Signature Date (Revised 6/2012) <br />