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� � <br />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 />wnnoceC• <br />for new construction: Short PlaUsubd <br />ress <br />�LICANT: _ Owner <br />NTRACTOR <br />— . . .� � � <br />Owner's Agent � Contractor <br />BUILDINfG PERMIT APPLICATION <br />PERTY TAX # <br /># <br />No. (attach copy of long legal description) <br />' COf1lf8CiOf S A90flt _ T0f18f11 (must provide a letter of consent from the ovmer to do work in the space) <br />State Lic. # f",{-�l��/�I C)IV��City Bus. Lic. #(:.5�� �i� <br />� � �wiZ�/'� IPhone/Email �^�,..J.�C- Y.7,7t, .��- <br />CO ACT FOR PERMIT <br />Phone/E-mail �v�i�L�f'(z?��� �1/�.S�Tr1{'j1,�.�. tc'� �CIS:-%Y4i- <br />CONTRACT PRICE OF WORK � a�C�L': C��G� <br />Existing Use of Building <br />Proposed Use of Building ( <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New �Addition _ Remodel Repair _ T.I. _ Sign _Sprinkler _ <br />DESCRIPTION O� WORK (additional space provided on the back) : � � <br />� �L S � �� C�� Ztr�+�; � `` � :,�� �„�.ti '�,v �� �. �� �)'v� , �'l�i. <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New �Addn _Alteration _Repair <br />Show Number # of fi�rtures <br />A/C — air handlin units <br />Forced air s stems <br />Gas i in <br />� Water heater <br />Gas fire lace <br />Gas range <br />Clothes dr er <br />Ran e hood <br />Exhaustfan <br />Heat um <br />Unit heater <br />� Boiler <br />rcerngerauon <br />Woodstove <br />� Other_ <br />NKLER/SU <br />of Heads <br />HEAT SOURCE: <br />_ Electric Other <br />�molition ChanQe of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />Lavatory (wash bas <br />Shower <br />Kitchen sink & disp� <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />eb <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 compl <br />with whether specifed herein or not. The granting of a permit does not presume to give authordy to violate or cancel [he provision of any other state or local law regulating construction <br />That I am authorize y the owner of this perty to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br />��� <br />/ S�e!� '�— �� I � � � `� <br />O r/Authorized Agent Signature Date (Revised 4/2015J <br />// <br />� • C,� 1h <br />7�� <br />