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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 />E ADDRES�: IPROPERTY TAX # <br />l���� i"�t /���r�. 5.�, ���ec�r�ff- w';�r `i�����`� u <br /># <br />iAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />^ <br />'NER ''�>C�': L t;', � Phone/E-mail G�..U,S :�-3 "J l�1Ci� j� C�. '-1 <br />ress � � � 5� J��'F, �� City�state/Zip .5�'c'.+�f� (.�,�-� � `'�'� � <br />'UCANT: _ Owner _ Owner's Agent _ Contractor _ Contractor's Agent � TBl1allt (must provide a lerier of consent (rom the owner to do work in the space) <br />NTRACTOR � �� w State Lic. # City Bus. Lic. # <br />ress Phone/Email <br />JANT BUSINESS NAME CONTACT FOR PERMIT :��`i�,�� �/c�s'EC •� �� ,_�; (e�,',�� �j <br />1 �� . r ,, ��C(1��:�'. C.' ; <br />> � ��I��/ �'�L�I f'��L ���� � -� � <;'%-�rf� �, .; <br />Phone/E-mail yC �.� <br />BUILDING PERMIT APPLICATION ICONTRAC�T PRICE OF WORK ��?�-��� � <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas_ Electric� Other_ <br />Building type: _ Single Family _ Duplex _Townhouse � Multi-Family _ Commercial <br />Type of project New Addition Remodel Repair T.I. Siqn Sprinkler _Demolition Chanqe of Use <br />DESCRIPTION OF WORK (additional space provided �n the back): �Er�lpvc,\ C� �- v:t��i���'�cf ;"�N��' c 4%�� ( r Q+�� r"�. ��— <br />Iti'c�:,���� i}='c--`at+; ;�'i�f: �j�e � Rrat��_j�' '��C��:;c ; C�e �; ��'t-L��''r�� �E',G� C� �{ E.f iiE��l�. `aC'�=�) �c���� �'►G";c�� <br />✓t'-t��'� ��e PIaCe (���;�� ct^c�e {'CesS:,,('e ��e l�e F Vc�� �i'N u n�tc ��;� o?r F� 1-� e��.� �� <br />� L i�i'�.Y�v'i� � 9� r�.��� � vi i;(� ���� �= 1-�� �-� r c� <br />MECHANICAL P�ERMIT APPLICATION PLUMBING 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 />f'� C'r e <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />� Kerngerauon <br />� Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESS <br />Number of Heads <br />SYSTEM <br />Type of Project: _New _Addn �Alteration _Repair <br />Show Number (#) of fxtures <br />Toilet <br />Bathtub <br />Lavato wash basin <br />Shower <br />Kitchen sink & disposal <br />E,�vt��,'� � Dishwasher <br />�;v�c;;r ,� Clothes washer <br />(��F'tic,;.t „.,,��� Water heater <br />Sink (service/bar/mop/etc.) <br />� Backflow preventer <br />Urinal <br />Drinkin Fountain <br />Floor drain <br />� Grease trap <br />Roof drains <br />Medical Gas <br />IOther: <br />Other: <br />I hereby certify lhat 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 compl <br />with whether specified herein or not. The granting of a permit does not presume to give authority to violale or cancel the provision of any other state or local law regulating construction <br />That I am authorized by the owner of this properly to perform the work forwhich application is made and I comply with the Slate Contraciors Law 18.27 RCW and 296.200A WAC. <br />) /i �. , , _ <br />��L�G��%C'�� .�1� �) iJ 1� <br />OwneflAuth rize' Agent Signature Date (Revised 9/2014) <br />��Z ' <br />