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• • <br />���IY1�� f1���0'1.r/"►���� <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 />ADDRESS: PROPERTY TAX # PERMIT # q <br />//°/%'i S� CI;,�r:; �-f' ✓i%�i11,��J %ll�l i� ' , . � t'S � ��) l� ����U <br />for new construction: Short PlaVsubdi <br />C��49�L�:a <br />PLICANT: _ Owner _ Owner's Agent _ Contractor <br />ONTRACTOR � '_ J�`' Q�t � <br />idress <br />��� � � <br />BUILDI PERMIT APPLICATIOIH <br />No. (atiach copy of long legal description) <br />Phone/E-mail <br />ICity/State/Zip � <br />� <br />Contractor's Agent ��T�nant (�,ushjProvide a lelter of conseN from tha owner lo do work in the space) <br />State Lic. # �.1 � / �-,�- <br />PhonelEmail <br />FOR PERIWC('! <br />one/E-mail' ��, <br />� 7��Gjty, Bus. Lic. # <br />� V � ' �l �� <br />r,s ,�'��'✓� ��O o� e � C�. <br />�� s- 2�, r� /h�r I � ti aMP� °�-�• <br />TRACT PRICE OF WORK q SG► GUC%' <br />Existing Use of Building �/�6ft!%1��'�'v%t HEAT SOURCE: <br />Proposed Use of Building /! Ffl�l�b� ��� � Gas�' Electric_ Other_ <br />Building type: Single Family _ Duplex _Townhouse _ Multi-Family ✓� Commercial <br />— . . <br />Type of project _ New _ Addition ✓ Remodel _ Repair �T.I. =Sign "�'�S��Sri�le��r'�_Demolition _Change .of Use <br />DESCRIPTION OF WORK (additional space provided on the back): <br />O�l �'t�O, � ✓ /L/ 11�Lo.t.��'' l .� �� � t,' ,r � <br />MECHANICAL PERMIT APPLICATION <br />Type 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 />� Gas range <br />� Clothes dryer <br />� Rangehood <br />Exhaust fan <br />Heat pump <br />� Unit heater <br />I Boiler <br />� Refrigeration <br />� Woodstove <br />� Ducting <br />I Other <br />SPRINKLER / SUPPR��S16F1 �l(S`�E�fl <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />; Toilet <br />� Bathtub <br />� Lavatory (wash basin) <br />� Shower <br />� Kitchen sink & disposal <br />� Dishwasher <br />� Clothes washer <br />� Water heater <br />� Sink (service/bar/mop/etc.) <br />� Backflow preventer <br />� Urinal <br />j Drinking Fountain <br />� Floor drain <br />Grease trap <br />� Roof drains <br />I Medical Gas <br />IOther: <br />� Other: <br />I nereby cerlify thal I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing ihis type of work will be complied <br />with whether specified herein or not. The granting of a permit does not presume to give auihoriry to violate or cancel the provision of any other staie or local law regulating construclion <br />That I am authorized by lhe owner o( ihis property to pertorm the work for which application is made and I comply with the State Contractors Law 16.27 RCW and 296200A WAC. ! I <br />_ �h ' � <br />/ <br />�O lr/Authorized � Date � (Revised 3/2013) <br />