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• � <br />PERMIT APPLICATION <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: /� <br />id� ����� ��5� � ��VZ <br />\L for new construction: Short Plat/subdivision <br />ER � �A N � QUS C. <br />�s �boo ( S r S� <br />.ICANT: _ Owner _ Owner's Agent %� <br />fRACTOR �GCJE -l-'LA-MP� <br />�(IG ZZo n+ ��Sc,J <br />BUSINESS NAME <br />PROPERTY TAX # <br />Lot No <br />V PERMIT # <br />I�`�Z� Ivl�����_ <br />(attach copy of long legal description) <br />Phone/E-mail "� (�S � j �f — S `j K <br />`� �I Q� City/State/Zip � �,n�� Vvi�i Qg z C7p <br />Contractor _ Contractor�S A98f1t _ T0f18f1t (must provide a letter of consent from the owner to do work in the space) <br />State Lic. #�L� C' F f' (-I g�S � City Bus. Lic. !t ��,9 <br />� C �LT, �¢� � i(iY j Phone/Email �2S � � � �– �- �,1 7 <br />r�.��7/l�0 L/�5-- � � / �" (� <br />Phone/E-mail [ � <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ;i�ODD � <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas Eiectric Other <br />Building type: �ingle Family _ Duplex _Townhouse _ Multi-Family _ Commercial � <br />Type of project: _ h--New Addition Remodel Repair T.I. Sign Sprinkler Demolition Change of <br />DESCRIPTION OF WORK (additiona�space provided on the back) : <br />�� �_ �uQ-n�9'G � C �r4�IG-�� C�l <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (1! of fixtures <br />A/C – air handlin units <br />Forced air s stems <br />Gas pipinq <br />Gas fi <br />Gas r <br />Ranqe hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Kitchen sink & d <br />Dishwasher <br />Water heater <br />Sink (service, <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certiTy 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 comp <br />wdh 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 />That I am authorized b owner of this property to perform the work for which application is made and I comply with the State ConVactors Law 18.27 RCW and 296.200A WAC. <br />� � __ �" �v 2�t <br />Owner/A brized Agent Signature ate (Revised 9/2014) <br />