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� <br />� <br />PERMIT APPLICe4TION <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.everetiWa.org <br />SITE ADDRESS: <br />� <br />PERTY TAX # <br />LEGA L for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER � ✓Z-�✓` '�'V � �j(�L�i Phone/E-mail L [�'% Z <br />Address /U2Ci �'l� CGcS/vtC� �-� City/State/Zip �.?�-`� ji.� � <br />APPL 1 CANT: _ Owner �Owner�5 A9C'fll _ COfl�f2C10f _ COf1lf8CfOf�S Ag0f1Y _ T0f18f1t (must provide a lelter of consent from the owner to do worK in the space) <br />CONTRACTOR �/�-� �"�''�-( State Lic. #�jkj�(,EC�/ �f�OS City Bus. Lic. # <br />Address �UZ� W C���d �� Phone/Email <br />I �`V�.r' r�eer} %��; � �� �'`,_��,/� `-��'7Sc��5z 6 <br />Phone/E-m U <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK T��� .�L� �, C,�OO <br />Existing Use of Building �p��N-�r�iiiG HEAT SOURCE: <br />Proposed Use of Building Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse kMulti-Family _ Commercial <br />Type of project: New Addition Remodel �C Repair _ T.I. _ Sign _Sprinkler _Demolition Change of Use <br />DESC RIPTION OF WORK (additrona/ spa e provide on the ack): / / <br />o— � r� ��v'�v l �l/� J�"', � '�'� J L��i- i,/' �C h o7'm�n-1 ��v0��1 Zd/ Z <br />�� � � � �,� ,�..-- �.,�- �� a�r <br />Gl w�!/ � p 1,�.,..�s �K-�-r-S -� <br />h P rpr ar#�i� ��M.,1�+�d � <br />ECHANICAL PERMIT APPLICATION PLU ING 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 />i 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 />1 <br />Woodstove <br />Ductin4 <br />Number of Heads <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />� Bathtub <br />I Lavatorv (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trao <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 governing this type of work will be complied <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 property to p rform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />/U ZG! %� <br />Owner/AuthorizedA nt�ignature Dafe (Revised3/2013) <br />li <br />