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���n�i�r �����c����Aa <br />�UILDIN�/ME�H�4NICAL/PLUMBING/SIGN/SPR1�91�LER/DEIiIiO�,ITION <br />CITY OF EVERETT P�RMIT SERVICES <br />3200 Cedar St., �verett, WA 98201 425-257-8810 FAX 425-257-8857 www.everetiwa.Qrg <br />PROPERTY TAX #t <br />for new construction; Short PlaUsubdivision Lot No. (attach copy of Ibng legal description) <br />ER <br />LICANT: Owner _ Owner's Agent <br />dress ���� <br />Phone/E-mail <br />City/State/Zip <br />CofltfaCtOf _ Cofltf aCtO(''S Ageflt _ Te�a�t (must provida a leqer of consent irom the owner lo dp work In the space) <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building <br />State Lic. # <br />Phone/Email <br />e/E-mail Sfr-�( �'_ `� S S"" <br />ONTRACT PRICE OF WORK <br />City Bus. Lic. # <br />HEAT SOURCE; <br />� Gas Electric Other <br />Proposed Use of Building � -�- — — <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 />��-�� f� i��Q,��� i C� �.��� hrt ti C-, s�?a.��; 1 �? / NC' ���L� <br />��t�cF-� (�('�t,�S �.�'l.o G��C�L_.. Pi(�,�G, I��sE (��BL3s� ����..5/��-1a <br />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 />Water heater <br />Gas fireplace <br />Clothes dry� <br />Range hooc <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />� Woodstove <br />I Ducting <br />� Other <br />SPRINKLER / SUPPRE�SION SYSTEM <br />Number of Heads <br />Type of Project: _New _Addn „�Alteration ^Repair <br />Show Number (#) of fixtures <br />5nower <br />Kitchen sink <br />Dishwasher <br />rn <br />se <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />-AAedie�l-6�s h�i <br />Other: L� <br />Other: E <br />I hereby certify that I have read and examined ihis application and know ihe same to be true and corre'c� All provisions of laws and ordinances goveming this iype of work will be complied <br />with whether specified herein or not. The granting of a permit does not presume lo give authority to violate or cancel the provision of any other state or local law regulating consiruclion <br />That I am a orize . y t ow lhis pe o perfor e work for which application is made and I comply with the State Coniractors Law 1827 RCW and 296.200A WAC. <br />�,��.:� i � <br />pW / zed gent Signature Date (Revised 4/2015) <br />