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� � <br />�,m .,� 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 />, ,� 23JJ3'�►-cl �e v�! <br />EGAL for new construction: Short Plat/subdivision <br />�WNERIVIUI V�I/� �l I�}�1 P ( � <br />Address � Li� �J?J ✓� � <br />APPLICANT: _ Owner _ Owner's Agent <br />CONTRACTOR <br />22-0�''` ,S'r S <br />ROPERTY TAX �t <br />Phone/E-mail <br />� <br />Contractor _ Contractor's Agent <br />�� � � 1'" l.�T�Y" � {:.— <br />BUILDING PERMIT APPLICATION <br />RMIT <br />No. (attach copy of long legal description) <br />�?-5--�22 - $ Z �I <br />�v�✓c tt . 1�1 i� �j g zo � <br />_ TBfl8flt (must provide a letter of consent from the owner to do work in the space) <br />State Lic. # �`jL��f ►� J�nv>(J � City Bus. Lic. #��� i/1 <br />ti <br />� � y � Phone/Email 2- <br />CONTACT FOR PERMIT <br />�tit. l ( Gl.�h <br />Phone/E-mail j v 1'f 0�V �� � <br />CONTRACT PRICE OF WORK <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair T.I. Siqn Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�� IC�.C� .���Z ��,���c;� <br />� � <br />� <br />=��1 I -�13 � <br />�1/l 6 N 1 Z <br />1�lN�c �JNI��fUv-� <br />HEAT SOURCE: <br />Electric Other <br />of Use <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn �Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br />Show Number # af fixtures Show Number # of fixtures <br />A/C – air handlin units Toilet <br />Forced air svstems Bathtub <br />Water heater <br />Gas fireplace <br />Gas ranae <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />Ductin <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Lavatory (wash basi <br />Shower <br />Kitchen sink & disoc <br />Clothes washer <br />Water heater <br />Sink (service/b� <br />Backflow prevei <br />Urinal <br />Drinking Founta <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />inside <br />I hereby certity 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 comp <br />with hether specified rein 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�am t�orized y the owner of 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 />I � �1 l � �� � � <br />Owner/Authorize ent Signatu Date �vised 4/2015) <br />