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� � <br />PERMIT APPLICATIOf� <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITIO�': <br />CITY OF EVERETT PERMIT SERVICES <br />��0 Cedar St.. Everett. WA 98201 425-257-8810 FAX 425-257-8857 www.everet a.ora <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ���"Q 2��� <br />ADDRESS: <br />C� � <br />TAX # I PERMIT # <br />�,�>�r �Cb�..C�r`� 1'ri-��>� <br />3AL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />A / ,,� � <br />'NER v� � ' `�� N , V c` � � . '%�f,� j" .�/�✓ � . Phone/E-mail <br />ress -� �� � � cJ � �.rZZ � � �City/State/Zip ,�'r y; v,t T'� '?s ��i S� <br />�LICANT: _ Owner _ Owner's Agent _ Contractor <br />NTRACTOR j'�gO;� t-/ /"IL�i!') ,� � ✓,I C� <br />f2SS �l: J � ^�,� � �/ �Jr �iV o �� <br />� <br />--� � / <br />� Q:J /i l"l �lJ � �! � i � � � <br />BUILDING PERMIT APPLICATION <br />COf1�f8CtOr5 i�9Bflt _ T@f18(lt (must provide a letter of consent hom the owner to do wnrk in lhe space) <br />��&iu�.#,�oivGF�'���skJ COEBus.Lic.# <br />��� :>-�/ / ��.1j � Phone/Email �/Zr� � L`� �`S % <br />CONTACT FOR PERMIT C `�+� �����y� �`,�„� •� <br />NTRACT PRICE OF WORK <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back)� <br />�S�-�'� d-�3 re w k�ro o�n, S i'n k`� � i S 1. w o c�,{ i- <br />OL <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />SPRI <br />Fvc — air nananng u <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Number of Heads <br />HEAT SOURCE: <br />Electric Other <br />of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn x Alteration _Repair <br />Show Number (#) of fixiures <br />Bathtub <br />Lavatory (wash basin <br />Kitchen sink & dis <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/baNi <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 that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this type of work will be complied <br />with whether specified herein or not. The granting of a permit does not presume to give authoriry 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 property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />�� I� � � '.�✓� , t/L <br />����� � . <br />Owner/Authorized Agent Signature Date (Revised 6/2012) <br />