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r <br />���� �oe,r~ �► �0-�� � `.T_� �i <br />� � <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 />ADDRESS: P �o�T�'j�x�O�' q',�� 1d I Y��m'I �I 1� <br />�T� � � � � 0 � �� ���J �� <br />�L for new construction: Short Plailsubdivision Lot No. (attach copy of long legal descnption) <br />` Phone/E-�a7 � � <br />ER P I�D AM�t.Od��1 __- <br />� j � ' �,y� CitylStatelZip � <br />ICANT: _ Owner _ Owner's Agent _ ontrar.tor _ Contractor's Agent _ Tenant (�,�s� c�o��a= a ieuer cr cc�se��!�o�„ �ne owner�o ao wn�k �� me sPace� <br />�oerTna i. iJl d� . i A i/�c State Lic. #�� J r! ( KJ City Bus. Lic. #Q �Z�j/ ,� <br />Phone/E <br />� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WC <br />Existing Use of Building <br />Proposed Use of Building <br />Buiiding type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercia� <br />T e of ro ect: Nevd Addition Remodel Re air T.I. Si n S rinkle� <br />DESCRIPTION OF WORK (addit�ona� space provided on tne back) : � <br />hl a.�'-d � i <br />Q� �� � <br />HEAT SOURCE: <br />Electrc Other <br />lition Chanae of Use <br />MECHANICAL PERMtT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair Type of ProJect: _New _Addn _Alteration _Repair <br />Show Number (#J of fixtures Show Number (#) of fixtures <br />A!C — air handlin units Toilet <br />Forced air s stems Bathtub <br />Gas i in Lavator (wash basin <br />Water heater Shower <br />Gas firepiace Kitchen sink & disposal <br />Gas range Dishwasner <br />Clothes dr er Clothes washer <br />Ran e hood Water heater <br />Exhaust fan Sink servicelbar/mo /etc. <br />Heat pump Backflow prev2nter <br />Unit heater Urinal <br />Boiler Drinkin Fountain I <br />Refri eration Floor drain i <br />Woodstove Grease tra <br />Ductin Roof drains <br />Other Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM Other: <br />Number of Heads 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 govemin� this type of work vrill Ue comp <br />whether specified herein or not. The granting of a permit does not presume to give authority ro violate or cancel the provision of any other state or local law regulating construc!ion <br />hat auth nz b e wner of this erty to perfonn the work for which appiicalion is made and I comply with the State Contractors Law 1827 RCW and 256200A `f/AC. <br />� ` � -15/ <br />Ow e Agent Signature Date <br />(Revised 9/2014) <br />`(� <br />�� <br />