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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 />: ADDRESS�„`` / PROPERTx TAX q PERAAIT # <br />� .�/-�" id' �l � E� -�l E�� /�� �D ��Q"�>� ��i �' v n i �� �� i1� ( � <br />for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />t Gc'v�/��� QU����/,� (// ���-� � Phone/E-mail /�,�, G� O` � L_ � <br />.3/D % C'D� ,�ii ��l/c�"� � City/State/Zip �!/�/�� <br />ANT: �Owner _ Owner's Agent _ Contractor _ Contractor's Agent _ Tenant �must provide a ie��er or consent rrom �ne owner �o do work in me space> <br />CONTRACTOR <br />ress <br />BUILDING PERMIT APPLICATION <br />State Lic. # <br />Bus. Lic. # <br />IPhone/Email ��7�"c'r� <br />FOR PERMIT��� ��r—� �;�" <br />�� �Z�so� 6.�91� �Pair/r���lE-�/f�;�l. d�6 <br />T PRICE OF WORK �� �� �ti G� <br />Existing Use of Building <br />Proposed Use of Building Gas <br />Building type: _ Single Family _ Duplex _Townhou e_ Multi-Family _ Commercial <br />Type of project: _ New _ Addition � Remodel V Repair _ T.I. _ Sign _Sprinkler De <br />DESCRIPTION OF WORK (additional space provided on the back): <br />��'�. f �/�',��'f .�' �' �c ��->`,-%�!�' �� <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 />� Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />I rtetrigeration <br />Woodstove <br />Ducting <br />Other <br />NKLER / SUPPRESSION SY <br />Number of Heads <br />HEAT SOURCE: , <br />Electric � Other <br />olition Chanae of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fixtures <br />; Toilet <br />; Bathtub <br />� Lavatory (wash basin) <br />I Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/e <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 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 ta give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I am �u�rized by the owner of this property to perform the work for which application is made and I comolv with the State Contractors i aw � a�� Rew a�.� �a� �nna �nmc <br />Owner/Autjipri�d Agent Signature <br />, �s� � <br />Date � <br />�c� <br />(Revised 3/2013) <br />