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� <br />� s�oz_ s-� -� � °`�-� � <br />PERMIT APPLICATION <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 />ITEADDRESS� pROPERTYTAX# PERMI # <br />; �c�:%�;` �`>c�� �� � ,� � o�134b71YDZ l�D j,� l � �? ' f� `�. <br />EGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />ER <br />ress <br />� <br />Owner _ Owner's Agent <br />T^ <br />' �s1.�-� r�..� <br />BUILDING PERMIT APPLICATION <br />� <br />_ Contractor'S A9B(lt _ T8f18f1Y (must provide a letter of consent from the owner to do work in the space) <br />Lic. # <br />Phone/E-mail /�b LSU �{J ' <br />CONTRACT PRICE OF WORK <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ <br />Type of project: _ New _ Addition _ Remodel _ Repair _ T.I. _ S <br />DESCRIPTION QF WOR i(addit onal sp ce providea on the back) : • <br />� <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Forced air svstems <br />Water heater <br />Gas fireplace <br />Ciothes dry� <br />Range hooc <br />Exhaustfan <br />Unit h <br />Boiler <br />� Other�,�Q,�i <br />SPRINKLER / SUPPRESS <br />Number of Heads <br />I NO City Bus. Lic.(1/ � � <br />� <br />.,�;�. fila.r � � <br />I��I� i <br />LILIt <br />HEAT SOURCE: <br />Electric Other <br />Commercial <br />_Sprinkler _Demolition Change of Use <br />� �� �.,, �.kr ��r� � � N�' �,.� <br />�-(/� /��C�1u� 'bu� �G{tr %�-if� <br />PLUMBING PERMIT APPLICATION <br />of Pro ct: _New _Addn _Alteration _Repair <br />how Number (#J of fixfures <br />Toilet <br />Bathtub <br />—� <br />Lavato wash basin <br />hower <br />Ki en sink 8� disposai <br />I DishJl�2sher <br />Clothes�vasher <br />Water heat@r <br />Sink service� <br />Backfl� <br />Urinal <br />Floor drain <br />Grease trap <br />Roof drains <br />Medicai Gas <br />Other: <br />Other: <br />n <br />I hereby certrfy that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this type of worlc will be comp <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 conslruclion <br />That uthori y t e ner of this pro rty to perfortn the work for which application is made and I compty with the State Contractors Law 18.27 RCW and 296200A WAC. <br />. �, <br />Owner/Au oriz d Agent Signature Date (Revised 4/2015) <br />( dnn <br />