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� <br />PERMIT APPLICATION <br />�UILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />GlTY OF EVEP.ET7' ^�RMIT Sc -�'cVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8010 FAX 425-257-8857 wv�nv.evereii�va.orc <br />SITE ADDRESS; <br />��1� �1 <br />for new construction: �Short Plai/subdivision <br />�OWNER <br />Address <br />APPLICANT: <br />CONTRACTOR <br />Owner _ Owner's Agent <br />�. <br />ROPERTY TAX # <br />Phon2/E-mail <br />City/State/Zip <br />Contractor _ Contractor's Agent <br />.,5 rv �o �Z��� rn;l\ (y�� <br />ANT BUSINESS NAME <br />; «• \rr�tr�t� SHop �er»odea <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building <br />Lic. � <br />� <br />No. (attach copy of long legal description) <br />T2f78�f (must provide a Ietter of consznt from the ov„ier to do work in th= sczc^1 <br />p� � ��LlPhone/Email yz ,yS <br />CY � J I ��..E OIT I� <br />Phone/E-mail y2�•U�)•%/„I„Q' <br />Bus. Lic. # 031� <br />C.Q �(7 ir�rt"�, � � <br />r�s-rle, �ro w n-Ei#� � �����.�� <br />NTRACT PRICE OF WORK �� CO <br />HEAT SOURCE: <br />Proposed Use of Building I Gas Electric 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 />�, C�� h� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New_Addn _Alterafion _Repair <br />Show Number (#) of fixtures <br />�_ A/C — air handlin units <br />� Forced air s stems <br />� Gas pipinq <br />� Water heater <br />�_ Gas iireplace <br />�_ Gas ranqe <br />� Clothes dryer <br />� Ranqe hood <br />� Exhaustfan <br />�_ Heat pump <br />� Unit heater <br />� Boiler <br />�_ Refrigeration <br />� Woodstove <br />� Ductinq <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />TypeofProject: _New_A��i� _Alteration_Repair <br />Show Number (�) of fixtures <br />I Toilet � - <br />� Bathtub <br />basin <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mopletc' <br />Backflow preventer (inside <br />Urinal <br />Drinkinq Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Ofher: <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 goveming this type of work will be comp <br />with whether specified herein or not. The granting of a permit does not presume to give authoriry to violate or cancel the provision of any oth2r siate or local latv regulating construction <br />That I am authorized by the owner of this property to perform the work for which application is made and I comply with ihe State Contractors Law 18.27 RCW and 296.200A WAC. <br />Ow er/Authorized Agent Signature Date <br />(Revised 4/2015) <br />