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J <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: �/( q� �p� PROPERTY TPX ft MI # (� <br />1 Z� L �� !�i: uLt'G�X: t.. C 1/�' �`�- �'� �' ��'�%�`c� ���t �No�-Sl� c� L� � � l��%�3 <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER � •�{_ Phone/E-mail ���-� �w � <br />Address �j�� � 0� �{�yV{ City/State/Zip � �c� i� q� �^r�+� � <br />APPLICANT: �Owner _ Owner�S Agefll _ COfllfaClOf _ C0�1f8CtOf�S A9@fl� _ T8f1Bf1t (musl provide a letter o(consent from the owner to do work in the space) <br />ress <br />CTOR l�! c.�: !'�' � <br />� <br />BUILDING PERMIT APPLICATION <br />L& I Lic. # COE Bus. Lic. # <br />Phone/Email <br />CONTACT FOR PERMIT <br />Phone/E-mail �� �'� G� � � � ���� <br />CONTRACT PRICE OF WORK � �d `'� <br />Existing Use of Building �i,��� F E-L��. ��, � S L��r�� � <br />� ',,� r <br />Proposed Use of Building SLi-wK <br />Building type: �Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additiona! space provided on the back) : <br />�� � r'� �e �� ar,i �� �/v i ndorn► w i�G-� a�� � <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 />I Water heater <br />I Gas fireplace <br />es aryer <br />Exh�ust fan <br />Unit h <br />Boiler <br />� Woodstove \ <br />� Ducting � <br />I Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />HEAT SOURCE: <br />Gas Electric Other <br />Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />; Lavatory (wash basin) <br />i Shower <br />� Kitchen sink & disposal <br />� Dishwasher <br />i Clothes washer <br />� Water heater <br />� ink (service/bar/mop/etc.) <br />I B kflow preventer <br />Urin <br />Drinki Fountain <br />Floor dra <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 lhe same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied <br />with whelher specified 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 authorized b wner of this property to per(orm the work for which application is made and I comply wilh the State Contractors Law 18.27 RCW and 296.200A WAC. <br />� r ��z <br />, ..:k�-D � `s- l2 <br />_ � ._ . . _ . _. . ,-._._ io..,,;.-,.,�aion�o� <br />