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� • <br />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 />TE ADDRESS:� ,`� � ��--..f jt /��' �� PROPERTY TAX N PE�IT�� !`�.� , U�Z <br />1 J r�- ; � U <br />:GAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />NNER � � y� .,�` � "�� Phone/E-mail ��,J --��f '��%' `� �1 cN P ���`� <br />dress %�C?� %����� J �, S�� City/State/Zip � �cj,r� '�y�f-� `��%� � <br />c�.�jov . � <br />PPLICANT: ✓ Owner _ Owner's Agent _ Contractor _ Contractor�S Ag0f1f _ T@I1811i (must provide a letter of conseM from the owner to do work in the space) <br />ONTRACTOR T�G �/ % ��,�,- C% L� State Lic. # City Bus. Lic. # <br />idress �, 1'l i� VU ��i(� � 1/ � Phone/Email <br />=NANT BUSINESS NAME CONTACT FO P IT . <br />�2 f=j i.�- � � <br />Phone/E-mail �1 cH„ �j��c:3� � Y�-it �c� ,G'��'1 <br />BUILDING PERMIT APPLICATION <br />ONTRACT PRICE OF WORK <br />Existing Use of Building %ie5', 0���1 L� <br />Proposed Use of BujJding Ke 5"��d e!� �z <br />Building type: v Single Family _ Duplex _Townhouse _ Multi-Family _ <br />Type of project: New Addition Remodel �Repair _ T.I. S <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�e� �� C � � t h-� ��c�C� .e � l�t S'�d'- � ; <br />MECHANICAL 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 />Gas piping <br />; Water heater <br />I Gas fireplace <br />i Gas range <br />! Clothes dryer <br />Rangehood <br />( Exhaust fan <br />Heat pump <br />Unit heater <br />, Boiler <br />rcerrigeration <br />Woodstove <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />Gas ElectricsC Other <br />Commercial <br />Sprinkler Demolition Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _,Repair <br />Show Number (#) of fixfures <br />! Toilet <br />Lavatory (wash ba= <br />Shower <br />Kitchen sink & disp <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow oreventer <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 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 bcal law regulating conslruction <br />That I am a thorized by the o ner of this p� perty to perform the work for which application is made and I comply with the State Contractors Law 18.27 RC W and 296.200A WAC. <br />��— <br />Owner/Authorized Agent Signature Date (Revised 3/2013) <br />