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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 />��, `�� ��r_ f�- ,�✓�� l:v <br />PROPERTY TAX # <br />ir# <br />LEGAL for new construction: ShoR PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER ���.�zr� ��,i (� .�..l.L �-- Co i'k-,A�r��l 1-�� U�� Phone/E-mail % C��� ��G ���-r7 c�,i� i: l���i( <br />ad� /�/i'oo �ri=zt�u,��a;.� /VL/�''J J ��:� l�� City/State/ZiF S�'�C�` l�,J,�! '���z� <br />T: _ Qwner _ Owner's Agent <br />NTRACTOR �� `,,T <br />ress (G13 � � % z ~ �1 /aU C� S <br />j'��1 i S71J "�� Fc��r�_� <br />_ ContractorQ'� Contractor's P,gent _ Tenant �m�5c Pro��de a letter of consent from the owncr to do work in the space; <br />State Lic. # (12' }:��`> `i � 14 �`��^ `� r � L� <br />�i�� �j City Bus. Lic. # t <br />�-t�t� �� �.�+ C� C'� Y�� � L Phone/Email Z S � -- !� 7 �. � � � � � <br />BUILDlNG PER9VIlT APPLICATION <br />CONTACT FOR PERMIT � ��� L/ <br />S,qit, /�'�t'1l.�C.�T"� � �' — 1`� t ` . <br />Phone/E-mail .7,�'� idi,f`r`i�/ (� %v p��'� j-( �r Y" r.U� �'")'til <br />CONTI2ACT P1210E OF WOR!( lZ�L�J+� <br />Existing Use of Building /1li l.-� HEAT SO! �RCE: <br />Proposed Use of Building ��%'I-o° G�. <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ <br />Tvoe of oroiect: �Ne� Addition Remodel Repair T.I. Si� <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�`nl.�r� c C�r or�J �-� ,Oc� C,c f�- ���^ �� ��� �✓ c� <br />MECGiANICAL PERMIT APRLiCA�IOLd <br />Type of Project: _New _Addn _Alteration _Repair <br />Sh.ow Number (#) of fixtures <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />' Gas fireplace <br />I Gas ranqe <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Commercial <br />Sprinkler <br />Other <br />Chanqe of Use <br />PLUMBINt'a RERMIT APRLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Sho� Number (#) of fixtures <br />Toilet <br />Bathtub <br />� �avatory (wash basin? <br />K.itch�r sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <br />�ink (sanrice/bs <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />�.' <br />I hereby certify lhat I have read and examined this application and know the same to be irue and correcL All provisions of laws and ordinances goveming this type of work will be compl <br />with whether specifed herein or noL The granting of a permit does not presume to �ive autherP.,� to viola!e or ancei the provision o' any olher state cr local law rec�ulating construr„ion <br />That I am authonzed by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. <br />l�v <br />Owner/Authorized Agent Signature Date (Revised 4/2015) <br />