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• <br />�'ERMIT APPLICATIO <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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />TE ADDRESS: PROPERTY TAX # PERMIT. # <br />c10� �a�;�:� �v� Zf33ZG/� �I�-��'(��` <br />=GAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />NER {�h��(, <br />Address <br />APPLICANT: Owner _ Owner's Agent ,� Contractor <br />CONTRACTOR Po�`�-(' j o 7�" �i�.2�- �a 7`� <br />Address 27 �i l O TH ,4 � E �� TALoM/�- <br />�iZM�E 5r" ��iz- oBG. YN <br />BUILDING PERMIT APPLICATION <br />Phone/E-mail <br />City/State2ip <br />Contractor's Agent _ <br />'a <br />Existing Use of Building �U��� �Gf I <br />Proposed Use of Building �� <br />Building type: _ Single Family _ Duplex _Townhouse _ <br />Type of project: New Addition � Remodel Repair <br />DESCRIPTION OF WORK (additional space provided on the backJ : <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 />' 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 />' Boiler <br />' Refrigeration <br />Woodstove <br />SPRINKLER / SUPPRESSION SYSTEM <br />[� Number of Heads <br />TetlBfli (must provide a letler of consent from lhe owner to do work in the space) <br />� L& I Lic. #�fLT1Z-yF Po�j L F COE Bus. Lic. # oL�� <br />18 t..fZ Phone/Email ZS}•37"j•Z'i,'�Z .�,��' .�tCie f�•re. <br />CONTACT FOR PERMIT <br />253•3'77•zZ� "2- ` I <br />Phone/E-mail �vlt,-t� a) �f �aT�.'!'� . �on� <br />CONTRACT PRICE OF WORK y, Z"7 2 <br />HEAT SOURCE: <br />Gas Electric Other <br />Multi-Family '✓Commercial <br />T.I. Siqn Sprinkler Demolition Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />' 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 />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 lrue and correct. All provisions of laws and ordinances governing this type of work will be complied <br />with whether specified herein or nol 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 authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. <br />r�v / CJ / �% <br />OwnerlAuthorized ent Signature Date (Revised 6/2012) <br />