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• <br />PERMIT <br />• <br />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 vwvw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ADDRESS: �j �/�/ }���%��}�}j� PROj�P)ERTY TAX # /� P�E7RMIT #{ <br />1 �� � � �l. � Y i' 1 � �'� \. • �-' ^�- � 1 / ���' ' � li l i 4J�T —7 - 1 �5' 7. � � �i �� �� li li. � � 1 � ! �� � --i�l � � <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />�ER HT�� �7'�"� t GI G�- ( <br />�SS ��'� 1 C �'�o ( �� v, ,�1t.�t �- �"t <br />LICANT: _ Owner _ Owner's Agent _ <br />� <br />ITRACTOR <br />'•ss �'�� t �1 �� I <br />Phone/E-mail <br />Contractor _ Contractor's Agent <br />�j � r� ��{�, �I � �� ( c ��; �r�c ��%c� <br />BUILDING PERMIT APPLICATION <br />L & I Lic. # <br />� <br />p �� , i���- � ► �� <br />T@fl2flt (must provide a letter of consent from the owner to do work in the space) <br />hone/Email <br />COE Bus. Lic. # <br />l:l tVK YtKMI l <br />, .,�,1/1� �.;1-�.��t�.t <br />31C, �.. -� -71 . r� <br />mail ��1�%r�. C. �'tA��) ,.(�J -i^��G;, � CiC��i C-.�, <br />ACT PRICE OF WORK I C7l �''�'-a � <br />Existing Use of Building �' �n�.,2i(?.1 G��iM�'% �.i:�jL_� HEAT SOURCE: <br />� <br />Proposed Use of Building ���' ��- 5�� �i"C�� �-'v�'11'1'���1(.�Lf"1 i,"�1'lS Gas Electric 4� Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family !/Commercial <br />Type of project: _ New _�Addition �Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) :�1?�•jy'� ��'.�_ C E �, �X �—G�;�b �'% <br />, � � , r ri r'�' <br />������5 ��C t`�Si�tt� (�� �'t.vy ��,�.���,�rizi5 �;�r�-� �S) ►'�.�w �e'�'�+z. ���i. i c �ck��,�� C ���' �'� � <br />� L � r <br />Vl..h 1 � '�G �'� � STl '' }^n �'��►'• i'S I � � x i �i'li'l� (,.t'�:.S�C G�i 5 �'Ct G� ;,'i"�- I'?` �1 � . <br />� <br />MECHANICAL PERMIT APPLICATION PLUMBING 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 />Water heater <br />Gas fireplace <br />Gas range <br />Gothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />Other <br />� SUPPRESSION SYST <br />Number of Heads <br />of Project: _New _Addn ✓ Alteration _Repair <br />Show Number (#) of fixtures <br />„ I Toilet <br />J I F�' aathtub <br />iower <br />tchen sink & dis <br />shwasher <br />othes washer <br />ater heater <br />nk fserviceJbar/i <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />otner: <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 governing this type of work will be complied <br />with 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 by the owner of this property to perform the work for which application is made and I comply with the State Contrectors Law 18.27 RCW and 296.200A WAC. <br />/ <br />� // `I � <br />�r;�^' ' ' - <br />,�"' ^ �'°Z�%2�',. �i��,r?.�'L� '"'/ �'`� � <br />vl� �. - j � <br />Owner/Authorized Agent Signature Date (Revised 6/2012) <br />