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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 />SITE ADDRESS• PROPERTY TAx # PE MIT # <br />j�Irs <ia'� �c��.���i S� 5i'�c� /li �2�� 5-/`��c���,i�Gv ��S�Z.'�}�'� <br />LEGAL for new construction: Short PlaUsubdivision �� fs :;�1�4L✓c� Lot No. (attach copy of long legal description) <br />OWNER p�, �.� '�� t � CJ� Phone/E-mail `�,� � v S �— / ��.� �� <br />address l �l S ',s `� � � i�'_tY� 1 � � C .� ,-��/ c � c�tyistateiz�p � �, .�%� � . � :� �! `��C� � <br />PPLICANT <br />NTRACTOR <br />ress � �` 7 <br />Owner _ Owner's Agent <br />-..t J6ih l�ut /`/`• <br />��, IIA,t� C:-A�, <br />Contractor _ Contractor�S AgBflt _ T@fl2flt (must provide a letler of consent from the owner to do work in the space) <br />L & I Lic. # <br />/_ �COE Bus. Lic. # � <br />4: � �l %r ,� � 7 I Phone/Email cj � l:' � �L`��' — `L� s � C-� <br />� I i+ !��['� � L�'N/tifiC, <br />�J �� PhonelE-mail y�„7 5 � �'S — �� S <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �: <br />Existing Use of Building _ 5; �� �e !"-��, l., �r��5, _�r,:2N <br />Proposed Use of Building � i �+� % riz�,,,, l:i h 1�5• .�r �� c% G, <br />Building type: �Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: k New _ Addition _ Remodel Repair T.I. Sign Sprinkler [ <br />DESCRIPTION OF WORK (addifiona/ space provide on the back) : <br />,� <br />� r J� rk � t� `x �s %��,� ,•�s s, � N� =�^t i�. �7�. .., �-l6w )h� sr �l �-lc�r�. <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 />� Gas fireplace <br />Gas ran e <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refri eration <br />Woodstove <br />Ductin <br />Other <br />SPRINKLER / SUPPRESSION SYS' <br />Number of Heads <br />HEAT SOURCE: <br />_ Electric �( Other <br />emolition Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Bathtub <br />Lavatory (wash basi <br />Shower <br />Kitchen sink & dispc <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mc <br />Backflow nreventer <br />unnai <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other. 5��,,,,,,y <br />Other: i,.a�,.n <br />I hereby certify that I have read and examined this applicalion and know the same to be true and correcL All provisions of laws and ordinances governing this lype oi work will be complied <br />with whether specified herein or not. The granting of a permit does nol presume to give authorily to violate or cancel the provision of any other stale or local law regulaling conslruction <br />Jfhat I am aulhonzed by. the owner of this property to periorm ihe work forwhich application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />` �/�\ <br />l /I /_ J j L , �/� <br />/G= � � � � Cc.�-✓C_ . '� —� � — � � <br />✓1 � <br />Owner/Authonzed Agent Signature Date (Revised 6/2012) <br />