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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 vwvw.everettwa.org <br />SITE ADDRESS:' <br />3�i G � � ���� � L <br />PERTY TAX # �/�''y3`KY��C>LCX���C <br />c��3�it��� 00 <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />q�,� (�:�� �.�.�..[c ;.� ��" Ca <br />OWNER �,,��2��j2t��T� IV1�L�j t _ , (�i Phone/E-mail `-C'�`� ^ 'Z�� -- -! �j � (�!j <br />iC� C'�o�� �T= <br />_ Owner � Owner's Agent <br />°�,�'P� � i��--� <br />City/State/Zip <br />'Z--� ( <br />Contractor _ Contractor'S Ageilt _ T@flaflt (must provide a letter of consent from the owner lo do work in the space) <br />C�ti ��..c�--x-s'[(.' �' E4s l tiii� � : <br />BUILDING PERMIT APPLICATION <br />State Lic. # <br />Citv Bus. Lic. # <br />� IPhone/Email <br />CONTACT FOR PERMIT � <br />��(Ahl �+-�-i�bi#�� <br />Z�.�2 �r-t< <�L'c�� � 2$� Z S 2- Z t 5� <br />Phone/E-mail 'r`�Y•� c� ��-,� 7 i�„2c �-k� i�t_Z�� Lz�M <br />CONTRACT PRICE OF WORK� /�'i, C.�L'�L`� "' <br />Existing Use of Building �/�LLN'�i� HEAT SOURCE: <br />Proposed Use of Building,��.:1%�'��1`� __ __ Gas� Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family �Commercial <br />Type of project: New Addition Remodel Repair � T.I. Siqn Sprinkler Demolition Chanqe of Use <br />DESCRIPTION OF WORK (additronal space provided on the back): �:X(-�F►.S�'� j�Q�'=L.�-��E' ll�� ��� , Vi�t1S ��.a..�.: <br />Il.i�i ?��-�- tJE�,v '�i� � o. �. G r s����E�� Sc�� ; G � � I�i -�, �r ��ts� �y� �I� <br />t=E7c5t.,%� G}pE�� ti�'S �a l�C�, �SS �-7z-J�r.S �.�5� � I��.: Ci �'t=-�2�lwt�a� <br />MECHANICAL PERMIT APPLICATION <br />ofProject: _New_Addn _Alteration_Repair <br />Show Number (#) of fixtures <br />A/C — air handlin units <br />Forced air s stems <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes dryer <br />� Range hood <br />Exhaust fan <br />Heat um <br />Unit heater <br />I Boiler <br />rtetri eration <br />Woodstove <br />Ducting <br />—� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />�`cl�i rL <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavato wash basin <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Medical Gas <br />'2 Other: ' t <br />Other: <br />I hereby certify that I have read and examined ihis application and know the same to be true and correct. All provisions of laws and ordinances governing lhis type of work will be compl <br />with whelher s ecified herein or not. The granting of a�ejmit does not presume to give authonty to violale or cancel ihe provision of any other state or local law regulating construction <br />That I a ut nzed by the ow rpf tYf 5-flrope perform the work forwhich application is made and I complywilh lhe State Contractors Law 18.27 RCW and 296.200A WAC. <br />/ , S�� � 4-J����� 1 <br />Owner/Au o ized Agen Signature Date (Revised 9/2014J `Z <br />