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� <br />L J <br />PE�IU�i7' APPLIC�TIORI <br />BUILDING/MECHANICAL/PLUM�ING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMII" SERVICES �ly{�� ;-v��� <br />3200 Cedar St., Evereft, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />ADDRES'C' / ,-/. - J /, PROPERTYTAX� <br />�/� %U ���< 'i�f'_ �/�_ I/ U� PERMIT #� <br />_ ,/7 ��� ,� �; � � �� ; �s �� M i�l � I — D 3 i <br />LEGAL for new construction: Short PlaUsubdivision Lot No (attach copy of long legal description) <br />OWNER�'/i�,�C�T %[�J�/'t��j C7(�-'r`','� ./'� � Phone/E-mail � �� �,j �j �. ��Z� <br />!' <br />��r <br />Address � �% ���� f J � � City/State/Zip �v��� `" ���e, ��j'���� �� <br />i <br />PLICANT: i/ Owner <br />CONTRACTOR E'i <br />Owner's Agent _ Contractor <br />ress <br />�ANT BUSINESS NAh�E <br />!� "' ������'L'W <br />�UILDING PERMIT APPLICATION <br />Contractor's Agent __ Tenant �musc prov�de a letter of consentfrom the owner to do work in the <br />State Lic. # <br />City Bus. Lic. � <br />� Phone/Email <br />NTACT FOR PERMIT���� ��;�� <br />ne/E-mail I��S. ���: C �� �� �'[��i%„%�,�J <br />CONTRACT PRICE OF WORK ���� . � � <br />Existing Use of Building ��j� <br />Proposed Use of Building <br />Buiiding type: _ Singie Family _ Duplex _Townhouse _ Muiti-Family _ Commercial <br />Type of project: _ New _ Addition _ Remodel �Repair _ T.I. _ Sign _Sprinkle <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />���/YC% �� l�!/1'! / C /�— ��17 ��/ �-- j <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 systems <br />Gas piping <br />Water heater <br />� Gas fireplace <br />� Gas ran e <br />Clothes d er <br />� Range hood <br />� Exhaustfan <br />_ � Heat pump <br />Unit heater <br />8oiler <br />Refrigeration <br />Woodstove <br />Ductin <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />Gas_. Electric %' Other <br />Demolition_ Chanqe of Use <br />PLUMBING PERMOT APPLtCAT10Pl <br />ofProject: _New_Addn _Alteration_Repair <br />Show Number (#) of fixfures <br />Toilet <br />Bathtub <br />Lavatory (wash basinl <br />Shower <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/ba <br />Backflow prever <br />Urinal <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />��� <br />I hereby certify that I have read and eaamined this application and know the same to be true and corred. AII provisions of laws and ordinances goveming this type of work will be compl <br />w�ith 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 />Ttiat 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 296.200A WAC. <br />��. �-,/.�' <br />Uwner/Auth z- Agent Signature Date (Revised 9/2014J <br />