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�ERMIi APPLICATICC� <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOL,ITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />SITE ADDRESS: PROPERTYTAX # P�E,,RMIT # <br />3� "���� � r� �- �� ci � F� i � LL' �, j�;�. ;_.�',-,`�� <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of Ibng legal description) <br />owNER ���f� �' ����L I��l V1�'1, I'Y1�U�C�-��� Pno�e�E-ma�i <br />Address G � i�,� ,L ��/��i City/State2ip <br />APPLICANT: Owner _ Owner's Agent _ Contractor _ Contractor�5 Ag2f7t _ Tef18�1 (must provide a letter of conseN from the owner to dp work in ihe space) <br />CONTRACTUR (�W �� �� State Lic. # City Bus, Lic. # <br />Phone/Email <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT 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 _C <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />� i- - <br />, �- <br />i1 � t � (_ ["t- � {' �, t. (�--�-<: N �. _ � L I L. ( D'LC <br />MECHANICAL PERMIT APPLICA7 <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Forced air systems <br />r ne <br />Gas range <br />Clothes dr <br />aust ran <br />HEAT SOURCE: <br />Electric Other <br />olition Chanqe of Use <br />Type of Project: �,New _Addn _,Alteration _Repair <br />Show Number (#) of fixtures <br />1 Toilet <br />�nower <br />Kitchen sink � <br />Dishwasher <br />Clothes wasF <br />Water heater <br />Unit heater urinai <br />Boiler Drinking Fountain <br />! Refrigeration Floor drain <br />Woodstove I Grease trap ' <br />I Ducting � Roof drains � <br />� Other I Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM ' Other: <br />Number of Heads i Other: �(; ,/(.. •� r � E� <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 herein or not. The granling of a permit does not presume to give authorily to violate or cancel the provision of any other state or local law regulating construction <br />Tha� authori d 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 296200A WAC. <br />% J <br />/-�,! : -'" � ---�._ Ci'�/�l /�c�/1 <br />(Revised 4/20i5) <br />