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PE�IlI�IT �4PPLIG/�TIO[V <br />gUILDING/M�CHANICAL/PLUM�ING/SIGN/SPRINKLER/DEMOL[TION <br />CITY OF EVERETT PERMI�' SERVICES � 141,�'7 -G�} � <br />3200 Cedar St., Everett, WA 98201 425-257-8810 F,AX 425-257-8857 w�vw.everettwa.org <br />ITEADDRESG• ,, �' PROPERTYTAX# <br />� �y ��>y�'� �� E- �,y� -� ; ;� PERMIT � <br />_ L5 ���ya�Ca��� � ���ic5� /1/l lyl I � U�� <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER ��,�c�/% G�L�J/��`j �(J �`'� .%'` �. Phone/E-mail J�, ���j =_ �� `� <br />Address �� ��� `J � � City/State/Zip ������ `���e' ���C� /� <br />� C� <br />PLiCANT: i� Owner _ Owner's Agent <br />CONTRACTOR L`Ti <br />ress <br />dANT BUSINESS NAME <br />-��j����"f,�`�'�z� <br />COf1t�8C10( _ COf1ff8CtOf'S AgBflt _ Tefta�f (must provide a letter of consent from the owner lo do work in the <br />BUILDING PERMIT APPLIGATION <br />State Lic. # <br />City Bus. Lic. � <br />I Phone/Email <br />NTACT FOR PERMIT���� ��;�� <br />ne/E-mail I��s. ���: � � �� �D���F� <br />CONTRACT PRICE OF WORK <br />Existing Use of Building ��j� <br />Proposed Use of Byjlding <br />Building type: �Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New _ Addition _ Remodel �Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORI4 (additional space provided on the backJ : <br />C, ��/v� �� l'��l C/�- // ����/�-- j <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Num6er (,=} of Fxfures <br />� A/C - air handlin units <br />Forced air systems <br />Gas piping <br />� Wafer heater <br />� Gas fireplace <br />� Gas ran e <br />� Clothes drver <br />� Exhaustfan <br />� Heat pump <br />� Unit heater <br />� �oiler <br />Refrigeration <br />Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />��c� , cr� � <br />HEAT SGURCE: <br />Electric �Other <br />molition_ Chanqe of Use <br />PLUMBING PERMET APPLtCAT10N <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />I Toilet <br />�avatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water he2ter � <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 1 have read and examined this applicatio� and know the same to be Vue and correci. All provisions of laws and ordinances goveming this type of work v✓ilI be compl <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 construction <br />Tfiat I a ori by t wner of this property to perform the work for which application is made and I comply with the State Contrac[ors Law 18.27 RCW and 296200A WAC. <br />' �� " � ��� <br />Uwner/Auth z- Agent Signature Date (Revised 9/2014J <br />