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• • <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBIiVG/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 />ADD <br />! <br />ur� � <br />PROPERTY TAX # <br />U/�'^� 3�i R�C%C c�C9 <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER ���� � � ' �;��;t'l Phone/E-mail �{ S.- j'7,� - ?jC� <br />Address � �(' � 5 �j/ City/State/Zip ( : ��`�!= j j/�f°��� �Q�'�x./ <br />APPLICANT: � Owner _ Owner's Agent _ Contractor _ Contractor�5 A9@flt _ TBflBflt (must provide a letter of consent from the owner lo do work in the space) <br />� <br />CONTRACTOR ��� ��q State Lic. # i _ City Bus. Lic. # <br />ress <br />SS NAME <br />BUILDING PERMIT APPLICATION <br />Phone/Email <br />vrv it�� rVK I'CKIVII I <br />7(V�s-t`�.�r' ���i�.�S <br />hone/E-mail �- �7L� " f/ % ' �0 �i U <br />ONTRACT PRICE OF WORK Z. �/!�i,� � <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas� Eiectric_ 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) :(�;,��/f ��7'sz �� �' � dv� �L. tz Q.� +S i,�Vt(�', <br />� yJ //J , y / <br />C�t✓l'���Nirj l�c� �fSc:it.�z� �,.,.i�'1 $�t�i�� U��vl '�-�G�'Ir^, cCG�Cx �h5lill�l! �UL1��=��C:/Y' � � '•1 'l.� <br />I T V��i , L C'. � l G("1C i'"l G✓' <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fixtures <br />� A/C — air handling units <br />� Forced air systems <br />Gas piping <br />! Water heater <br />! Gas fireplace <br />i Gas range <br />; Clothes dryer <br />� Range hood <br />j Exhaust fan <br />Heat pump <br />; Unit heater <br />� Boiler <br />� Refrigeration <br />j Woodstove <br />�?�, I Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />� PLUMBING PERMIT APPLICATION <br />pe of�?�oject: _New _Addn _Alteration _Repair <br />,�``�, Show Number (#J of fixtures <br />� � Toilet <br />� ' Bathtub <br />j'=. Lavatory (wash basin) <br />� Shower <br />� < Kitchen sink & disposal <br />DiShwasher <br />; Clot+�es washer <br />Sink (senrice/bar/m <br />Backflow p�eventer <br />Urinal <br />Drinking Fount�in <br />Floor drain ��. <br />Grease trap ` <br />Roof drains <br />Medical Gas <br />Other: <br />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 ihis 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 1827 RCW and 296200A WAC. <br />' �(v <br />�.. l0 �-r 3 - � � <br />Own Authorized Age t Signature Date (Revised 3/2013) <br />