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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 />TAX # <br /># <br />� ��!'►�l ' L � li-�- i��1 {, c� �� !'� �� � O I�,DU -' : ; � . <br />, � n ����� <br />for new construction: Short PlaUsubdivision �� �'ji'(,���-1� ,�t„i� )���,-�- �Lot No. � ch copy of long legal description) <br />t � �%�� � %tii Y" / I � Phone/E-mail �5 ~ � "7 /� i �%% �/�i.! 1��[.R'/ : <br />� D� 2..C��1'L I�-��i City/State/Zip �t,� 4..�'�.,� � 1� ,? �-C <br />ANT: _�Qwner _ Owner's Agent _ Contractor _ Contractor's Agent _ Tenant �mus� Provide a �ener or consenf eom me ow�er �o ao wo�x �n tna <br />ACTOR � �'� ��(r State Lic. # Citv Bus. Lic. # <br />PERMIT <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK L °% <br />Existing Use of Building C'.�G�'�'2..�� ��"' HEAT SOURCE: <br />Proposed Use of Building U W'`��L �`' Gas Electric <br />Building type: V Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New _ Addition � Remodel Repair T.I. Si n Sprinkler Demolition Chan <br />DESCRIPTION OF WORK (additional space provided on the back) : � r <br />t�c: G..e�� �.l�: �r� �S ri ►:..v�,— �!E-,2��t..� "T'G� 2.� �c.. Z y <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Aiteration _Repair <br />Show Number (#) of fixtures <br />� A/C — air handling units <br />I Forced air systems <br />Gas pipinq <br />� Water heater <br />I Gas fireolace <br />Clothes dry� <br />Range hooc <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeratioi <br />Woodstove <br />Other <br />/ SUPPRESSION SYSTEM <br />Heads <br />of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of Trartures <br />� Toilet <br />I Bathtub <br />Kitchen sink & <br />Dishwasher <br />Clothes washe <br />Water heater <br />Backflow <br />Floor drain <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 goveming this type of work will be compl <br />with whether specfied herein or not. The anting of a permit does not presume to give authorily to violate or cancel the provision of any other state or local law regutating construction <br />That I ar aut orized by th ner of thi roperty to perfo e work for which application is made and I compy with the State Contractors Law 1827 RCW and 296.200A WAC. <br />J/) / <br />� l <br />6 �'�_ � G3, (�.� <br />Owner Authorized gent i ature Date (Revised 9/2014) <br />r� <br />