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�ERMIT APPLICATIO� <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: <br />� � � <br />for new construction: Short PlaUsubdivision <br />ER C=.>,/ ��r: t' <br />ss � 1%t. �L �l'�) �I <br />.ICANT: _ Owner <br />f RACTOR <br />;5���,�c2. L <br />►NT BUSINESS N/ <br />TAX # <br />Lot No. <br />Phone/E-mail <br /># <br />(attach copy of long legal description) <br />/ <br />1 �'1[..s'MitXl �]S+L_'�' �. Jl:� ICity/State/Zip �,.. �/ � fl c_ �� .� ��-�1 ,� � 2_ <br />Owner's Agent Contractor _ Contractor�S Ag@f1t _ T6f1811f (must provide a letter of consent from the owner to do work in the space) <br />- �; � State Lic. # ' ~ � c '� L � City Bus. Lic. # ` � �'] ' "+ <br />� .- � �1 Phone/Email ' � - i�, � � � -- (_ ' <br />CONTACT FOR PERMIT <br />� i`�-� • ���t�C,.--�ch:,h�..�--�'S� S�r..:�C,.�- •C�ez�v <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ►� <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />T e of ro'ect: New Addition Remodel Re air T.I. Si n S rinkler Demolition Chan e of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />'�.7 4i �-C. ��� S�C.�I� �,n5 � Z�,,Y1 L �G.�� �,C',r' ,�„ �y�.c.k,�- � <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration �Repair <br />Show Number (#) of fixfures <br />; A/C — air handling units <br />i Forced air systems <br />Gas piping <br />I Water heater <br />� Gas fireplace <br />Gas range <br />� Clothes dryer <br />Range hood <br />i Exhaust fan <br />Heat pump <br />Unit heater <br />E Boiler <br />Woodstove <br />� Other �,r�,_ r�., ..�n.. <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fxfures <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 (inside <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <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 comp <br />with whether specified herein or not. The grantlng 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 />That I am authorized by the owner f this property 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 />r � , <br />, <br />_� t � �.� �� � . — / ��� <br />wner/Authorize Agent Signature Date (Revised 4/2015) <br />