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• <br />u <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 />SITE ADDR <br />LEGAL for new construction: Short Plat/subdivision <br />OWNER �C`�''� �--�C�`�ht;: ��! <br />t <br />Address I, , y N,. ,�' <br />i <br />APPLICANT: _ Owner _ Owner's Agent <br />CONTRACTOR ��;r J"l �--�(l?s,L'j�'�y�L� <br />dress "�j�"`1 �le�<�� f�'i�ti <br />:NANT BU INESS NAME <br />PROPERTY TAX # <br />�- `i����'/ <br />PERMIT # <br />Lot No. (attach copy of long legal description) <br />� Phone/E-mail '1 L�;! ,1'L}�j .1(..��,��-" <br />City/State/Zip <br />COf1tf2CtOf _ COf1�f2CtOf'S Ag2(li _ T@f1811i (must provide a letter of consentfrom the owner to do work in the <br />State Lic. # -�(= �,C_ �1����'�� City Bus. Lic. # �l ��(,-� <br />i''.�;[•'�r"-� 7 r �� i) .�� � Phone/Email ��'`i� �.� l v K Z'S / <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ <br />Type of project: New Addition _ Remodel _ Repair <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />L+ �-G ( �l �'�:=� V�� ;Fc,tr`v�.�'�,�—� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C - air handlin units <br />Forced air s stems <br />Gas pipin <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes dr er <br />Ran e hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Phone/E-mail <br />CONTRACT PRICE OF WORK <br />HEAT SOURCE: <br />Gas /l Electric Ot <br />Multi-Family _ Commercial <br />T.I. Sian Sprinkler <br />C. L�l,%�l,+.t Cj `� �' i�'I�t <br />J <br />Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fi�ctures <br />Toilet <br />Bathtub <br />Lavatorv (wash basin) <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 certity that I have readayd examined this applicalion 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 whether specified�herein ofnoL 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 authoiized by lhe�owner oYlhis pro,perty to perform the work for which application is made and I comply with the State ConVactors Law 1827 RCW and 296200A WAC. <br />J l r / `-1 /r � <br />()wner/Authorized Agent Signature Date (Revised 9/2014) <br />/ <br />