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• <br />►�J <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERlDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />E ADDRESS: PROPERTY TAX q PERMIT # }� <br />?�,��� °`� �.�s ���-� � �C;2� ��ti z r-% (�J j � C' � ' �''.� <br />�AL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />..� r � � <br />'NER �:'G�7�'�'� 1 i" l.k� L L L-- Phone/E-mail����>'l1.'"���� i a��� .� ���� <br />ress � � r�° . �_�., I f���. � 1 + City/State/ZiP (��` �.; �� �`,;� { �'� {i� �" ���$ <br />'LICANT: Owner _ Owner's Agent _ Contractor _ Contractor�5 A9@IlY _ T8fl8flt (must provide a letter of consent from the owner to do work in the space) <br />NTRACTOR {7 i� �'�` 1 �°_ i�1 L. L- �'� � � <br />State Lic. #{� � G t�.1 L i��� dE ' aus. u�. # <br />ress �..1-� �Z t,...�' j j 4:}��r� .;;.� %- Phone/Email _5 i7il ) I� �i)�/ai� <br />JANT BUSINESS NAME CONTACT FOR PERMIT �.,�.',���.� �"'. � <br />Phone/E-mail r�'yni� k� i..�' <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK _ <br />Existing Use of Building ����� ��C �'r°� i'Y'1 ► �..► <br />Proposed Use of Building ��N��t� ��'_ �1� Gas <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition �� Remodel _ Repair _ T.I. _ Sign _Sprinkler De <br />DESCRIPTIQN OF WORK (additional space provid,ed on t e back) : ,_.,_s ��_ <br />; � <br />��� 1'`+ � C.7(:r�. L � r.�i-::� i fi� t..- r�� 7�t�° �'Y t� r I!\i`�� ��,�iC�:`� a �; C'_i.-<_'� <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New_Addn �Alteration _Repair <br />Show Number (#) of fixfures <br />A/C - air handling units <br />� Forced air systems <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes drver <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />INKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />Other <br />r�iv «/� <br />�C� -- <br />C�l�-- <br />_ ��� � <br />Chanpe of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: �New _Addn _Alteration _Repair <br />Show Num6er (#) of fixtures <br />2 Toilet <br />� Bathtub <br />� Lavato wash basin <br />Shower <br />/ Kitchen sink & disposal <br />j � Dishwasher <br />/ Clothes washer <br />Sink (service/bar/i <br />Backflow preventE <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 thal I have read and examined lhis application and know the same to be true and correct. All provisions of laws and ordinances governing lhis type of work will be compl <br />with whether specified herein or not. Th rantin of a permil 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 by t e ow of t prop to perform the work forwhich applicalion is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />�' - ��21-15� <br />� ��� i <br />O er Authorized Agent Signature Date (Revised 9/2014) � <br />