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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.everetlwa.org <br />SITE ADDRESS: <br />LEGAL for new construction: Short PlaUsubdivisi <br />OWNER I�I'�hJ j��['� p�,] � ��" � <br />ress �f cit`jc`� �QA!'✓l� �1C�11 <br />'LICANT: _ Owner _ Owner's Agent <br />CONTRACTOR <br />� 7! `� � �� d _I� � <br />SINESS NAME <br />Contractor <br />� ��� `� ����v a ' <br />BUILDING PERMIT APPEefCAT1�N <br />PROPERTY TAX q <br />Jy t; ; _ �t� <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail S6�f/ �'�l �_5r� '� <br />Contractor's Agent � T0118i1► (must provide a letter of consent from the owner lo do work in lhe space) <br />��//�$t�at� Lic. # <br />Phone/Email <br />Bus. Lic. # <br />--2 � ���.� � / <br />hone/E-mail ��(rj " �.�-� '�� �"�% � � <br />ONTRACT PRICE OF WORK �U�� � <br />Existing Use of Building <br />Propased Use of Building <br />Building type: � Single Family _ Duplex _rownhouse _ Multi-Family _ <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign <br />DESCRIPTION OF WORK (additional ace provided on the back) :��S�-�' <br />�a� k�� ���0 �i,✓�,� , <br />C'�IECIiANICAL PERMIT APPLICATION <br />Type of Project: New _Addn _Alteration �_Repair <br />Show Number (#) of fixtures <br />i A/C — air handling units <br />i Forced air systems <br />; Gas piping <br />Water f�eater <br />� Gas fireplace <br />; Gas range <br />Clothes dryer <br />Range hood <br />j Exhaust fan <br />j Heat pump <br />; Unit heater <br />' Boiler <br />� Refrigeration <br />Woodstove <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />Electric Other <br />Commercial <br />_Sprinkler _Demol <br />Q��g` T��J <br />Change of Use <br />P/�o�u�� �S� <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />! Bathtub <br />i Lavatory (wash basin) <br />j 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 />� Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />� Medical Gas <br />� Other: <br />Other: <br />I hereby certify thal I have read and examined this application and know the same to be true and correct. All provis�ons of laws and ordinances governing this type oi work will be complied <br />wiih whether specified herein or not. 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 />That I am authorized the ow r of this property to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. ( <br />� O I �I� <br />� � �� <br />Owner/Authorized Agent ignature Date (Revised 3/2013) <br />