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�ERMIT APPLICATI� <br />�UILDINC/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOL,ITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.ev rettwa.or <br />� �.-�:, r� -�� i�r <br />ITE ADDRESS: <br />� 3 D S� F✓�.tf- !-ua.t r c.�n..,, Ev. <br />EGAL for new construction: Short PlaVsubdivision <br />ER �( Q,.�.�ILS'Ic C�A�c 4T� G,k <br />ress <br />8 <br />TAX # <br />�T # <br />No. (attach copy of Ibng legal description) <br />Phone/E-mail �,t..S � 7,So ^ Q� <br />City/State/Zip <br />APPUCANT: Owner � Owner's Agent _ Contractor _ Contractor's Agent _ Tenant �must provide a ieuer ot consent trom ine owner �o dP work in ihe space� <br />ress <br />BUILDING PERMIT APPLICATION <br />State Lic. # City Bus, Lic. # <br />Phone/Email <br />c;�N i Ac: i� �� rtrcmi i S C.' ( e�• O S <br />4z� - Oc�43 `� �ere k P �� <br />Phone/E-mail ei� f%V�'CdI�S��v ['�y^� �Mq <br />T <br />CONTRACT PRICE OF WORK _ <br />Existing Use of Building C��-OT-f/�C- HEAT SOURCE: <br />Proposed Use of Building ��1�-1L��- 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 />��r��Lt4�ttr Ek P��1 �G��O�c/j 5(`�l�G IL���oc��p N� �tl��J �l.� S��p�e�/ �d.S <br />� � �" <br />S i'�� c/� r w S�-1'l �� ni� N.e._w c� � R.c r�c s� -r`� P'� o �� <br />MFCHANICAL PFRMIT APPLICL►TI�N PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn ,�.Alteration _Repair <br />Show Number (#) of fixtures <br />A/C - air handling units <br />-� Forced air systems <br />vvaterneate <br />Gas fireplac <br />Gas range <br />Clothes drye <br />Range hood <br />Exhaust fan <br />Unit heater <br />Boiler <br />i Ketngeration <br />� Woodstove <br />I Ducting <br />! Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Type of Project: _New _Addn ,�,Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />Kiccnen sinK � c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Urinai <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />ide <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 />wilh whether specified herein or not. The nting of a permit does not presume to give authority to violate or cancel the provision of any other siate or local law regulating construction <br />That I am authorized by the owner of t s pro erty to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />�-�►i' S. 7 - f - !j <br />Owner/Authorize Ag t Signature Date (Revised 4/2015J <br />lI, <br />l <br />