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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ITE ADDRESS: PROPERTY TAX # PE�MIT # <br />_ /yi � �c�t sf ��/ c/%if � � , ,,► <br />�' �� �I,���i?C)�� <br />EGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />�WNER ' (,�j N�,L. Phone/E-mail ��� —� �7 �j3�� <br />�dress�%��� /i/[~�%� �� Jt�l/�� L✓� /�/� City/State/Zip �.,�=t�i� ,' �,1,� '/�S'��� <br />PPLICANT: _ Owner _ Owner's Agent ,� Contractor _ Contractor'S A9BIlt _ T@f1211t (must provide a letter of consent from the owner to do wrork in the space) <br />ONTRACTOR� ��lJ< � �jj; � L& I Lic. # COE Bus. Lic. # <br />�dress ��ul� ��"� j �1� j� , �v.%l � l� "� ��'�� % Phone/Email y� J �� "J�� Vj�-�� <br />�i ��'1 �a �/<'�.l <br />�� �� � � Phone/E-rr <br />BUILDING PERMIT APPLICATION CONTRA <br />Existing Use of Building L,��J( ����'��' <br />Proposed Use of Building <br />`���;�r `�-ZS�- 5�/5�`'�5 � i <br />" /,'<��/rr��n�h5 �( <br />PRICE OF WORK �J �. %� <br />r <br />HEAT SOURCE: <br />Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: _ New _ Addition _ Remodel _ Repair T.I. Sign Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />.5 fd ��-�J ��.��i� <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fixtures Show Number (#) of fixtures <br />' A/C — air handlin units Toilet <br />Forced air s stems i Bathtub <br />' Gas piping Lavatorv (wash basinl <br />iter heater <br />s fireplace <br />s range <br />dhes dryer <br />n e hood <br />iaust fan <br />at pump <br />It heater <br />ler <br />friperation <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSION S <br />` Number of Heads <br />5nower <br />� Kitchen sink & disp� <br />j Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />� Backflow preventer <br />� Urinal <br />Drinking Fountain <br />; Floor drain <br />' Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby ceRify 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 nol presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I am aut�d by the owner of this property to perform the work forwhich application is made and I comply wiih the State Conlractors Law 18.27 RCW and 296200A WAC. <br />�� <br />��� L �' � <br />�� �� % �� _ � �� <br />Owner%Auth�rized Agent Signature Date (Revised 6/2012) <br />