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• <br />• <br />P��NEIT RPPLIGATIO[� <br />BUILDIIVG/MECHANICAL/PLUM�IN�/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT pEF:MI� SERVICES � <br />3200 Cedar St., Evereft, WA 98201 425-257-8ii10 FAX 425-257-8857 www.everet wa org � c( <br />SITE ADDRES�• �' <br />� � ��j��� � � ��/'- <br />LEGAL for new construction: Short PlaUsubdivision <br />OWNER /`"�%��e�� T �DL/�/�� F��%'r�/�Cd <br />'SS �G� ,�5 � <br />LICANT: �Ow�ner <br />TRACTOR L�' �7: <br />` O <br />'a / 'J � � <br />Owner's Agent Contractor <br />ss <br />\NT BUSINESS NAME <br />������`���� <br />�UILDING PERMIT APPLICATI�N <br />PROPE�R/IY TAX # I F4 V 1 I��i I� U Z <br />�� � 7 d��i � C� j��(� ! C� Ci <br />Lot No. (2ttach copy of long legal description) <br />� � Phone/E-mail � � 5 �,j � . � � � � <br />City/State/ZiP ����� ` ���t% �j���� /_� <br />o C <br />COf1ff8Ci0�'sAgent _Tenant(musipro�id=aletterofconsentfromtheovmertodoworkinthespace) <br />State Lic. � <br />Bus. Lic. � <br />IPhone/Email <br />CONTACT FOR PERMIT���� ���� <br />Phone/E-mail IL�S . ���: � �� �L� �'Qf�%%���/f7f:% <br />CONTRACT PRICE OF WORK �/�Ci. (:/Z� ' <br />Existing Use of Building ��C"� HEAT SGURCE: <br />Proposed Use of Building Gas Electric � <br />Building type: _ Singfe Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New _ Addition _ Remodel �Repair _ T.I. _ Sign __Sprinkler _Dernolition Chan <br />DESCRIPTION OF WORK (additional space provided on the backJ: <br />�l��"l/v� �' <�����/�— /! ����/��- j <br />MECHANICAL PERMIT APPLICATION <br />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 d er <br />Ran e hood <br />Exhaust fan <br />Heat pump <br />� Unit heater <br />� aoiler <br />Refrigeration <br />� Woodstove <br />I Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Other <br />of Use <br />PLUMBING PERMET APPLtCAT10N <br />Type of Project: _New_Addn _Alteration._Repair <br />Show Number (#) of fixtures <br />I Toilet <br />Bathtub <br />Lavatory• (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that 1 have read and examined this application and know the same to be frue and correct. AII provisions of laws and ordinances goveming ihis type of work will be compl <br />with whether specified herein or not. The granting of a permit does not presume to give authonty to violate or cancel [he provision of any other state or local law regulating construction <br />Tliat 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 18.27 RCW and 296200A WAC. <br />' /'� " � -�� <br />GwnerlAuth z- Agent Signature Date (Revised 9/2014) <br />