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�oe r � � 0 — �� � �c�s� e � <br />�► � <br />PERMIT APPLICATION <br />BUILDING/MECHANICALlPLUMBING/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 />S�,� :°,°�ES �,�c�� o�jcl i�BT��� l���D I OU?�� I� P�I� �I i— <br />�l I J� <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />, 7 <br />OWNER P 1 �� � �AA_.�i�i/�t/1 _ Phone/E �ai � L � <br />OR <br />Owner _ Owner's Agent � <br />1 <br />City/State/Zip <br />COIl�fBCfOf'S /�9Bflt ` Te�B�t (must provide a letter of consent Gom the owner to do werk in the suace) <br />State L+c. <br />Bus. Lic. # <br />� � PhonelE-mai� � ] � <br />BUILDING PER IT APPLICATION CONTRACT PRICE OF WO '�;�� q�� �� <br />�� <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commerciai <br />Type of project New Addition Remodet Repair _ T.I. Siqn Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK {additional space provided on the bacF <br />r • . <br />,�a� � o� � ���,(,�� 3 �� <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixiures <br />A/C — air handling units <br />Forced air systems <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes dr er <br />n e hood <br />Exh st fan <br />Heat p <br />Unit heater <br />Boiler <br />Refri eration <br />Woodstove <br />Ductin <br />Other <br />SPRINKLER / SUPPRESSION SYS' <br />Number of Heads <br />�,C��I��..S�'.k C���, <br />PLUMBING PERMIT APPLI ATION <br />Type of Project: _New _Addn LAlteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & dis osal � � <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/baNmop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other:'F� pp('Z <br />Other: <br />I hereby certify that I have read and examined this application and knovr lhe same to be true and correct. All provisions of laws and ordinances goveming ihis type of work will be comp <br />whether specified herein or not. The granting of a permit does not pre,sume to give authorrty to violate or cancel the provision of any other state or iocal law regulating construction <br />hat auth riz b e v✓ner of this erty to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br />1 ` a -I 5� <br />pw e Agent Signature Date (Revised 9/2014) <br />iia �� <br />���, <br />S ,�CG4 <br />