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� <br />PERMIT APPLICATION <br />BUILDING/MECH,ANICAL/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 />DDRE <br />PROPERTY TAX # <br />PERMIT # <br />�. ����`� <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER ���-��)(�,�) '7 �j`•G Phone/E-mail <br />r�J� � l � ._I" r �� Q <br />Address �.�J" � j ���"' �'�L_ �, City/State/Zip �`, � �� U,.� � (��� � <br />APPLICANT: �-SJwner _ Owner's Agent _ Contractor _ Contractor�S A(JBflt _ TellBflt (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR <br />ress <br />,� �-� ��,��� � � �a.�� h��; C�i �- <.� <br />BUILDING PERMIT APPLI�CATION <br />, e � <br />tate Lic. # City Bus. Lic. # <br />Phone/Email <br />ONTACT FOR PERMIT <br />hone/E-mail <br />ONTRACT PRICE OF WORK ��ia %�� <br />Existing Use of Building Y t-�1� Y'v't`tA \ �� <br />Proposed Use of Building�� <br />Building type: �Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New _ Additior� Remodel _ Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />l ti1-{� V� c"3�f� V�TYIc`��.1 <br />�(�1';v-P,��- �";.t� la �Y,E' ��: � �— f"� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� A/C — air handling units <br />/ 1 Forced air systems <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 />i Ketrigerati.on <br />i Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRE:SSION <br />Number of HE�ads <br />HEAT SOURCE: <br />Other <br />of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fixtures <br />� Toilet <br />' Bathtub <br />i Lavatory (wash basin) <br />�� j Shower <br />� I Kitchen sink & disposal <br />� i Dishwasher <br />� i Clothes washer <br />Sink (service/bar/m <br />Backflow preventer <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 />��ith whether spe ified 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 aut riz d by the own property to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />�; `7 11--1� l� <br />- �`7 - Sl � � <br />Owner/Authorized ent ' nature ate (Revised 3/2013) <br />✓�/ <br />