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, <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 vwvw.everettwa.org <br />E ADDRESS: PROPeRrr Tax a PERMIT #^�_ ^�\ <br />�r_;,�;.r�i�����if.a�,.l /���7 �e�r:vo�l'f- ��n�A— 11r�G�i�,u�S�Or,rar��� Clnl��''C� Uv <br />AL for new construction: Short PlaUsubdivision IV �I,l, '.' � 1� ,Lot <br />JER � N �� � ;)(,�.�;�k--� Phone/E-mail <br />;ss ^ "_�� (�' l�� ��-��l�G��� /"lv�• City/State/Zip <br />LICANT: � Owner _ Owner's Agent _ Contractor _ Contractor's Agent <br />ONTRACTOR <br />BUILDING PERMIT APPLICATION <br />State Lic. # <br />No.l '!'(attach copy of long legal description) <br />�"� I" I b�/���� � V��Y� SeG� � i'�{LZ1� .(,{,'i1�1 <br />����� i�� 1/�l� , � °��..t1 I <br />T2flBflt (must provide a letter of consent from Ihe owner to do work in the space) <br />I Phone/Email <br />CONTACT FOR PERMIT <br />`-�)c,.",^.S'g - m�l�- 1 <br />Phone/E-mail ��I�����,�'d���"� <br />CONTRACT PRICE OF WORK <br />Existing Use of Building � <br />Proposed Use of Building L'fY�K�i � <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project }( New Addition Remodel Repair T.I. Siqn Sprinkle <br />DESCRIPTION OF WORK (additional space provided on the back): <br />�,�� �n �f-c�-r ;� c�n C�n.�C <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: �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 ranqe <br />Clothes dryer <br />Range hood <br />Exhaustfan <br />Heat um <br />� � Unit heater <br />I Boiler <br />Refrf eratfon <br />Woodstove <br />Ducting <br />—� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />BUS. L�C. $k <br />HEAT SOURCE: <br />Chanae of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: �New_Addn _Alteration _Repair <br />Show Number (#) of Fxtures <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/mo /etc. <br />Backflow reventer <br />Urinal <br />Drinkin Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />� � I Other: � ' G <br />Other: <br />I hereby certiry ihat I have read and examined this application and know lhe same to be true and correct. All provisions of laws and ordinances governing this type of work will be compl <br />with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision of any other slate or local law regulating conslruction <br />That I am aulhorized by the owner of this property lo pertorm the wcrk forwhich application is made and I comply with the State Conlractors Law 18.27 RCW and 296.200A WAC. <br />�/ �)// <�L/ S�— <br />"�i7Lf��'-'l1L-r1�j�-- % �S� � �",_. <br />Owner/Authorized Agent Signature Date (Revised 9,�2014) � <br />. ' /�� <br />� � � ' <br />