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� <br />PERMIT APPLICATI <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 ADDRESS: -�?� ,r PROPERTY TAX # PER IT /# <br />L—����f� /ci�''r%�'• �rC`� +�� ;'L`��r �/, �'�'`, !)t3� ;.� ?l'i/�" t7r5s'�:��� �� t �� U ' � i'/ <br />_ � <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER Gc'v�/�E_// Ql/S•�/'�� (� .i%�/ �° Phone/E-mail /Z.�G �J ` � L � <br />Address �/Q � �Q� ✓� i ��(�C, C. City/State/Zip �v��� � <br />APPLICANT: �Owner _ Owner's Agent _ Contractor _ Contractor's Agent _ Tenant (m�st provide a iener or consern rrom ine owner�o do work in tne space� <br />ONTRACTOR <br />BUILDING PERMIT APPLICATION <br />State Lic. # <br />Phone/Email <br />City Bus. Lic. # <br />CONTACT FOR PERMJT � ' ---�;.�" <br />��J/� ��i `" i <br />Phone/E-mail / Z`��, �Od� 63�D ��/�������9� diQC� <br />CONTRACT PRICE OF WORK �� /'� �'� <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas Electric � 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): <br />�i�f/��. ����/�E"�' � ������IN� � , /�i�/a � l_`,�i��" �f��f= <br />MECHANICAL PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />� Forced air systems <br />j Gas piping <br />Water heater <br />� Gas fireplace <br />I Gas ranae <br />SPRIN <br />c;�otnes aryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />Other <br />I SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />( Bathtub <br />Lavatory (wash basin) <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 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 this type of work will be complied <br />with whether specified herein or not. The granting of a permit does not presume ta give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I am ut rized by the owne� of this property to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />9--/.s--/y" �i� , <br />Owner/Au ri d Agent Signature Date (Revised 3/2013) <br />