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. � <br />• <br />PEi�MIT APPLICATION <br />\ J <br />�tJILDING/MEGHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />GlTY CF `VEP,ET`T rERM1T �G�cVICES <br />3200 Cedar St., Everett, WA 98201 425_257-8810 FAX 425-257-8857 www.everettwa.ora <br />� <br />SITE ADDRESS: <br />ERTY TAX # <br />�� <br />LEGAL for new construction: Short PlaUsubdivision � <br />Lot No. (attach copy of long legal description) <br />OWNER <br />APPLICP,NT: Owner <br />CONTRACTOR <br />Address "�"� ��� <br />TENANT BUSINESS I <br />1'�i�v�� �(:�S <br />Owner's Agent � Contractor <br />BUI�DING PERMIT APPLICATION <br />Existing Use of Building <br />Phone/E-mail <br />CitylState/Zip <br />COf1t�8CiOf�S Ag2fll _ T2f72f11 (must provide a letter of consent from lhe ovmer to do work in the spzce) <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse <br />Type of proj2ct: New Addition Remodel Repair <br />DESCRIPTION OF WORK (additional space provided on the back): <br />t'�G� C 72� L1��� s <br />i�.�\�,�C� C �� ti1eUL�S <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#J of fixtures <br />� A/C — air handlin units <br />�_ Forced air systems <br />�_ Gas pipinq <br />� Water heafer <br />�_ Gas fireplace <br />� Gas ranqe <br />� Clothes dryer <br />� Ranqe hood <br />� Exhaustfan <br />� Heat pump : <br />� Unit heater <br />� Boiler <br />�__ Refrigeration <br />� Woodstove <br />� Ductina <br />SPRINKLER / SUPPRESSION SYSTEM <br />INumber of Heads <br />State Lic. # t^ �r °Iv.it�; <br />��f<(j�� �Phona/Email L��� ���-' <br />CONTACT FOR P IT <br />�. �p,"�SS l�� ��� I ��'�`� <br />��.,..._,� __:,, �-�r'. ��.�i. -y. . ,� � . <br />CONTRACT PRICE OF WORK <br />Bus. Lic. # <br />HEAT SOURCE: <br />Gas_ Electric_ Other <br />Multi-Family _ Commercial <br />___ T.I. Sign� Sprinkler _ Demolition Change of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_qddn _Alteration _Repair <br />Show Number (#J of fixtures <br />I Toilet �- <br />� Bathtub <br />�_ Lavatory (wash basin) <br />� Shower <br />� Kitchen sink & dis osal <br />� Dishwasher <br />� Clothes tvasher <br />� Water hea�er <br />�_ Sink (service/bar/mop/etc ) <br />� Backflow reventer (inside bld ) <br />� Urinal <br />�_ Drinkinq Fountain <br />� Floor drain <br />� Grease trap <br />� Roof drains <br />� Medical Gas <br />IOther: <br />IOther: <br />I hereby cer[ify that I have read and examined this application and know the same to be true and correc�. Ail provisions of laws and ordinances goveming this type of work will be comp <br />with whether specified herein or noL The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />I am authorized b he owner of this property to perForm the work for which appiication is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />' , r L � � ` I <br />� % % <br />� Ow er/Authorized g nt Signature Date <br />(Revised 4/2015) <br />