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� � <br />PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLERJDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 vwvwr.everettwa.org <br />ADDRESS: _, , <br />PROPERTY TAX # <br />f,- <br />for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />� \, F�� d. �.( �Z �.Ic�JC PhonelE-mail 1,t[.��m Id,��C ��('� �%il 11'LC++(.� • Gi' .'Y1 <br />5"l L7 l�ii�:��'b� IkIJJ_ I�'�tyistate�cip L'J��frliLT . LtJ���' v1 y,�:r.� f <br />T: � Owner _ Owner's Agent _ Contractor _ Contractor's Agent _ Tenant tmust proviae a iener ot consent trom me owner �o do wonc m u,e space> <br />fOR ���•�' State Lic. #�� � �, '' j �� S S P l� City Bus. Lic. # <br />S d-L � :�G'. s^Gr'/C_ � '� j�' , C,1Ji\- PhonelEmaii l'.� �j - Z`7 y-- i v' S�D <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />PRIGE OF WORK <br />Existing Use of Building � v� ' lC'i l � <br />Proposed Use of Buifding �'� v� � U <br />Building type: � Singie Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition � Remodel Repair _ T.I. _ Sign _Sprinkle <br />DESCRIPTION OF WORK (additional space provided on the back): <br />�'�rv`��'�,� L�c.�'G�,,'� c�,�- s� M.� ✓i � c�: (;�,1;;, 5h,: <br />� , <br />������ �� <br />MECHANICAL PERMiT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixiures <br />A/C — air handling units <br />Forced air svstems <br />Gas fireplac <br />Gas range <br />Clothes drye <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Kerngeration <br />Woodstove <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />HEAT SOURCE: <br />of Use <br />/I�LtL(yvi �/�� <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of ��rtures <br />', Toilet <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Ciothes washer <br />Water heater <br />Backfiow <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />�'I�� <br />• � �, <br />! hereby certify that I have read and examined this application and know the same to be true and corrad. All provisions of laws and ordinances goveming this type of woric wiN be comp: <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 consVuction <br />That I am authorized by t ner of this properiy to perform the work for which appfication is made and I compiy with the Stale Con[ractors Law 1827 RCW and 296200A WAC. <br />�U �'�� <br />Owrter/Autho rzed Agent Signature Date (Revrsed 4/20>5) <br />