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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.everetfirva.org <br />ADDRES : <br />��a f � <br />•; � <br />PROPERTY TAX # <br /># <br />for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />ER <br />_', <br />',� �°�a'��t�'lC'ta9�. <br />( � 7 F'S �' � f%e• I V� ICitY/State/Zip ��C'tiT"�-�P W f� ��J ��7 <br />:_ Owner _ Owner's Agent _ Contractor _ Contractor's Agent � T0f18�t (must provide a letter of consent from tbe owner to do work in the space) <br />� <br />, ".�,. , �.,.,,,.�...,., ..�...� � <br />�� i � ��� Pr� i �f� �('' <br />BUILDING PERMIT APPLICATION <br />State Lic. # <br />��15�I 7�b� <br />PRICE OF WORK '� �.77C.r%� <br />BUS. LIC. # <br />f.3�� t�a'n �'i <br />r�tan�„�e,� <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 />T e of ro'ect: New - Addition Remodel Re air T.I. ' Si n S rinkle� Demolition Chan e of Use <br />DESCRIPTION OF WORK (additional space provided n the back) : Reo'►'��r9c'i1 � o��,n�t���ac a�e � p�� �+ Q�� �"�� `��' <br />% 1 � � �d Cc�K ��o���� ��.! d�� �ll t���l� �C�1 {�.car�� h���y <br />i,�a.5�e � t,.�c:5t�' ��r1 �c' R� � <br />�/e��� Re�tate ���,-c��e Pc�ss�f� ��e��e� v�.`�� �� t����,��.��- �-4�t�e�': <br />G�f�v�- � 1 � a [ �i � �� K --� `� <br />MECHANICAL P RMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New '_Addn �Alteration _Repair Type of Project: _New _Addn ,�Aiteration _Repair <br />Show Number (#) of Fxtures Show Number (#) of fxtures <br />A/C — air handling units _ � Toilet <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes d er <br />p�e �.. Ran e hood <br />Exhaustfan <br />Heat um <br />Unit heater <br />� Boiler <br />Refri eration <br />Woodstove <br />Ductin <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />oi w�rvci <br />Kitchen sink & <br />Dishwasher <br />Backflow <br />Urinaf <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined this appiiration and know the same to be true and correct. All provisions of laws and ordinances goveming 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 violate or cancel the provision of any other state or local law regulating construction <br />That I am authorized by the owner of this properiy to pertorm the work forwhich application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />_..._ �... �..e- <br />Owne Auth rize Agent Signature Date (Revised 9/2014) <br />