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�ERMIT 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 - PROPERTY TAX # PE{{{����MMIT # <br />7.'_ 7 : . „-. � <br />i .'���; -� ,"��';%/ � f— f ��'%f";;; ;';�`T% �'��J��3:�; ^i<: ,��; �`c� i �d <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER Gc'��/L�� Q//.��/��/> (� ./J/�,/��` Phone/E-mail /Z,�G �O f � L � <br />Address ��� / L0��7' /�(/� C City/State/Zip �v���%% //,C,7 <br />Owner _ Owner's Agent _ Contractor _ Contractor�5 A92�i _ T0f18f11 (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR <br />ress <br />BUILDING PERMIT APPLICATION <br />State Lic. # <br />Citv Bus. Lic. # <br />� Phone/Email <br />ONTACT FOR PERMIT��� �� �� <br />ione/E-mai� �G'•�J L'�d� 63�C� �c�i�/�/����9. �iQ�� <br />ONTRACT PRICE OF WORK � �f% �'� <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 />.t�.G'i/'✓�� f �i��%�i� �' C� �'-"�r��/�� ! �J%f/►��:f� ��/'�/?.J����i�'f- <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />� Forced air systems <br />Water heater <br />Gas range <br />Clothes drye <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteretion _Repair <br />Show Number (#) of fixfures <br />� Toilet <br />I Bathtub <br />Shower <br />Kitchen sink & disp <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Ffoor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that t 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 to 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 owner of this property to perform lhe work for which application is made and I comply with the Stale Contractors Law 18.27 RCW and 296.200A WAC. <br />� s �, �fz �� <br />�/ / <br />OwnerlAu ri d Agent Signature Date (Revised 3/2013) <br />