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� <br />� <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRtNKLER/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 />ADDRESS: PROPERTY TAX # PE,�2A�{T ^ � <br />�,1 �- l G� //'� /� G C-� � I/f� � y 1�� <br />►L for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />ER / /-� (/ / /��% /:� (J ,� � � G �i Phone(E-mail %/ � ,l✓ �� �j� Z � � <br />;s �llj � � f G 1 �� . % Lt� City/State/Zip C f/ � %/ C / / �N � �y � <br />�� 3y <br />=�=TC.� Y 2 �/ �C„�.' <br />� ��4 �.�� <br />.ICANT: � Owner _ Owners Agent _ Contractor _ Contractor's Agent _ Tenant (musc P.o�ide a iene� or conse�i r.om me owne� co do wor� �n me sPace> <br />fRACTOR O� k� L 8� I Lic. # COE Bus. Lic. # <br />Phone/Email <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building �� �l � n-�''� �" L <br />Proposed Use of Building �{� �� G� <br />Building type: �Single Family _ Duplex _Townhouse _ Multi-Family _ Commerciat <br />Type of project: New Addition Remodei � Repair _ T.I. _ Sign _Sprinkler _[ <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />1�v �,�� � �,�1 `Tr�T�i r1 � i- I�i� 1' f'GG �,f' r�- ���`'� L C,=� <br />��� TG�, <br />MECHANICAL PERMIT APPLICATION <br />of Project _New _Addn � Alteretion _Repair <br />Show Number (#) of fi�rtures <br />1 A/C - air handling units <br />� Forced air systems <br />Gas piping <br />Water heater <br />! Gas fireplace <br />Clothes dryer <br />Range hood <br />+ Exhaust fan <br />,� Heat pump_ <br />' Unit heater <br />Boiler <br />Refrigeration <br />i Woodstove <br />/ I Ducting <br />' Other <br />SPRINKLER / SUPPRESS <br />Number of Heads <br />HEAT SOURCE: <br />of Use <br />/i /� �7� � % � /� <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repafr <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Kitchen sink 8� dis <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/i <br />Backflow preventE <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medicai Gas <br />Other: <br />Other: <br />I hereby certify that I have read and examined this application and know the seme to be true and correct. All provisions of laws and ordinances goveming this [ype of work will be complied <br />with whether specfied herein or noL The granting ofi a permii does not presume [o give authority [o violate or cancel [he provision of any other state or iocal law regula6ng consWction <br />That I am authorized y the owner of this property to perforrn the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. <br />�� � � � � <br />n orized Agent Signature Date (Revised 6/2012) <br />