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� <br />� <br />F'E�111�iT �OPPLICATION <br />BUILDIfVG/MECHAN(CAL/PLUM�ING/SIGN/SPRINKLER/DEMOLITION <br />C{TY OF EVERETT PERMI�" SERVICES �,�y(;�. �,, ]� <br />3200 Cedar St., Everett, WA 98201 425-257-8810 F,AX 425-257-8857 www.everettwa.org <br />ITE ADDRESS•�/C� „V7�� j ✓ � <br />! l� �f � <br />LEGAL for nevd construction: Short PlaUsubdiv <br />OWNER ���.�� /T �%�L/�//�(`� <br />Address �� � f,� f��f <br />APPLICANT: V Owner _ Owner's Agent <br />CONTRACTOR � f7,�"'l <br />ress <br />JANT BUSINESS NAh9E <br />�'/���. �`�'�� <br />PROPERTY TAX # PERMIT� #f <br />L��yr3C��C�j��c:)ICS� ���-t�� -� <br />Lot No. (attach copy of long legal description) <br />���J�� ,/'% �• Phone/E-mail � � ��Ej . � � � � <br />� City/State/Zip ����� `' l��f' ����� �� <br />COf1tf2CtOf _ COf1tf2CY0f'S Ag2f1i _ T2112f1Y (must provide a Ietter of consentfrom the owner to do work in the space) <br />Lic. # <br />Bus. Lic. # <br />IPhoneiEmail <br />CONTACT FOR PERMIT����� ����� <br />Phone/E-mail I�-S. ���_ `�.�J� �� �Q�/�%„�� <br />BUILDING PERMIT APPlICATION ICONTRACT PRICE OF WORK `�r''v .�� <br />Existing Use of Building ��/� <br />Proposed Use of Building <br />, ✓ . <br />Gas <br />HEAT SGURCE: <br />Building type. _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New _ Addition _ Remodel �Repair _ T.L _ Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />l. ! ��'"�/�� �' lJ�� Tr�/<- ���%! �/�-- � <br />MECHANICAL PERMIT APPLICATION PlUMBING PERMET APPL{CATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (�) of fixtures <br />� A/C — air handlinq units <br />� Forced air systems <br />Gas piping <br />� Wafer heater <br />� Gas fireplace <br />� Gas ran e <br />Clothes d er <br />Ranqe hood <br />� Exhaustfan <br />_ Heat pump <br />� Unit heater <br />3oiler <br />Woodstove <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />�avatory (wash basi <br />Shower <br />Kitchen sink & dispc <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mc <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 certiFy that I have read and examined this application and know the same to be true and corred. All provisions of laws and ordinances goveming this type of worlc will be compl <br />with whether specified herein or not. The granting of a permit does not presume to give authority to vioiate or cancel the provision of any other state or local law regulating construction <br />That I a ori by t wner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. � <br />' ��� �-�� <br />Uwner/Auth z Agent Signature Date (Revised 9/2014J <br />