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P��I�EiT �OPPLIC�lTION <br />BUILDING/MECHANICAL/PLUM�ING/SIGN/SPRIN�fLER/DEMOLITION <br />CITY OF EVERETT PERMI�" SERVICES (�;4�;�!-�i�g <br />32U0 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />SITE ADDRESG• �/ ,..- /t Q PROPERIYTAX„ <br />� �Q %�J �/`�� S� �f7 �J. v PE/� MIT <br />. L�taC%d��%c'��`��OJLSt'> >I����� ��C� <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />/� > _/ �/ <br />OWNER �/C�� �L�J�f✓(`] �"Y(%'r�//'C.� .%'/� �, ohone/E-mail _�� ��f�' .- �� L- � <br />Address ��% � �� f��� � City/State/Zip �v��� `� ��f, ����a �� <br />APPLICANT: �Otimer _ Owner's Agent _ Contractor _ Contr2Ci0f�S A�2�f _ TE�2f1i (mustprovide a letter ofconsentfrom the o�vier to do work in the sp <br />CONTRACTOR ��� [ State Lic. � City Bus. Lic. �# <br />�����6��� <br />BUILDItdG PERMIT APPLICATION <br />Existing Use cf Building �, <br />IPhone/Email <br />CONTACT FOR PERMIT �,��� ��;�� <br />c� ��- <br />Phone/E-mail J�L�S. ���_ � �T �� �`D�%„�� <br />CONTRACT PRICE OF WORK ��C?S C*7� <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex_Townhouse � Multi-Family <br />Type of project: _ New _ Addition _ Remodel �Repair _ T.I. <br />DESCRIPTION OF WORK (addifional space provided on the (iack) : <br />�1 ��/�� �� �r/�lT�� �r ��%'�/�.� <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 dryer <br />� Ranqe hood <br />� Exhaustfan <br />_ Heat pump <br />Unit heater <br />8oiler <br />I Woodstove <br />� Ductinq <br />� Other <br />SPRINKlER I SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SGURCE: <br />Gas_. Electric /Other <br />Commercial <br />_Sprinkler_Demolition Change ofUse <br />PLUMBING PERMET APPLtCAT10N <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />I 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 certrfy that I have read and examined this application and know the same to be true and correct. AII provisions of laws and ordinances goveming ihis rype of work will be compl <br />H�ith whether specified herein or not. The granting of a permit does not presume [o give authority to violate or cancel the provision of any other state or local law regulating construction <br />Tfiat 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 1827 RCW and 296.200A WAC. <br />��� ���� <br />Owner/Auth z- Agent Signature Date (Revised 9/2014) <br />