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� <br />• • <br />PERlVIIT APPLICATION <br />BUILDING/MECHANICAL/F'LUMBING/SIGN/SPRINKLERJDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES � �i� ��{_. � �,� <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />SITE ADDRES�• <br />����E �kf= � � <br />LEGAL for new construction: Short PlaUsubdivisio <br />OWNER �� i�'t�T/ fJDL��/ic/E, r� <br />Address �� � ���. ��J � <br />APPLICANT: �Owner _ Owner's Agent _ <br />CONTRACTOR ��j� <br />ress <br />PROPERTY} AX S� <br />6�r`— �'��� t1�.> !�c>`�'�3c�� � �.. P�T(�-I ] I- D <br />Lot No. (attach copy of long legal description) <br />R � �' � n � <br />� � � ./'/ � Phone/E-mail _� � . G „��_. � � ` f <br />� City/StateiZip �v��� ` ��f, ����� �� <br />COnVBCtOf _ ContfBCtOf S Ag8f1t _ T0n8flt (mustprovide a letter ofconsentfrom the owner to do work in the space) <br />I tIVHIV I tSU�IVtJJ IVAMt // L�7 0 �/ E' I (!r <br />���E � �'1��. . <br />�� /� <br />BUILDING PERMIT APPLICATION <br />� <br />Lic. # <br />City Bus. Lic. # <br />�Phone/Email <br />CONTACT FOR PERMIT �'�e��� /,1��-�---F� <br />/�� / � <br />Phone/E-mail .7L�S�SG�O : �.� �C� %�D����:/������. <br />CONTRACT PRICE OF WORK ��' �� . CfZ� <br />Existing Use of Building J /� HEAT SOURCE: <br />Proposed Use of Building Gas Electric <br />Building type: _ Single Family _ Duplex _Townhouse Multi-Family _ Commercial <br />Type of project: _ New _ Addition Remodel �Repair T.I. Sign Sprinkler Demolition Chan <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />��-t���`'' �- �L`�� l�/,�/"�O`�. e��-��l /��' � <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 svstems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />3oiler <br />Kerri eration <br />Woodstove <br />� Ductinq <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Othe <br />of Use <br />PLUMBING PERMET APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtu�es <br />I Toilet <br />� Bathtub <br />Lavatory (wash basin <br />Shower <br />Kitchen sink & dispos <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/moF <br />Backfiow 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 cerYrfy that I have read and examined this appiication and know the same to be true and wrred. All provisions of laws and ordinances goveming this type of work wiit be compl <br />with whether specified herein or noL The granting of a permit does not presume to give authonty to violate or cancel the provision of any other state or local law regulating construction <br />That I a ori by t wner of this proper[y to perform the work for which application is made and I compiy with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />/ �! " � _�� <br />GwnerlAut� z Agent Signature Date (Revised 9/2014) <br />