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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 />SITE AD E S: � PROPERTY TAX t# PERMIT # <br />�0�`� w e�s��a `�v ��+�r- �6�=� � � � r���rr� � o �� <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER 6b�t 1� G Phone/E-mail <br />Address �� W� 3��� I7�S U�"�"�� City/State/Zip 5,���, W� ���9"z�,(�� <br />APPLICANT: � Owner _ Owner's Agent _ Contractor _ Contractor's Agent _ Tenant �must proviae a ieicer orconsent trom me owner io do work in �ne space� <br />CONTRACTOR '7� � <br />U/i�.%i� �.t/1TJE'J,Y>�10� State Lic. # Ti).�,UL= L(' �.3 7 �'L Citv Bus. Lic. # C���-��(� <br />BUILDING PERMIT APPLICATION <br />Phone/Email <br />:ONTACT FOR PERMIT <br />�� DC�A`i EfL g �5-�..3�'0 �� � <br />'hone/E-mail ,���,RY- G . �}�y�, � � <br />:ONTRACT PRICE OF WORK �f�, UL'k� <br />Existing Use of Building I"bF'b HEAT SOURCE: <br />Proposed Use of Building M FC7 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 />CU��T�.,u�1' n��w '�-��.�<ys r���si� ; � .r>�� �i-o �a� �r c'��,v�.� �,�az � t., �i�z.�i �,�-- .��� <br />�r.� � C'�ca.�r�..£N�=L /Z('i��� �atiV,�' vN�� �..,...>F�-��� %.o�e�-- 7Z� r? S"��iP..!'��,E /'��r� • P�u� vr ��� <br />L� I�I.L s�G J r J,t %Zc' �'.�I/-Y� ,�c'L11 /i51�/h/'s L%�/ 5'U� iEtij>tiiJ L�)Li'ti( i�� �l�/.L i- <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units_ <br />� Forced air systems <br />I Gas aipina <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESS <br />Number of Heads <br />ION SYSTEM <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fixtures <br />� Toilet <br />I Bathtub <br />Shower <br />Kitchen sink & dispo <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mo <br />Backflow preventer <br />Drinking Fountain <br />Floor drain <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 the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied <br />with whether specified herein or not. The granting of a permit does not presume ta give authority to violate or cancel the provfsion of any other state or local law regulating const�uction <br />That I am authorized by the owner of this property to perform the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. <br />10 2�i /S <br />Owner/ Ffori ed Agent Signa re Date <br />(Revised 3/2013) <br />