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• <br />5� <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 />� I (� � �- �� / (� <br />SITE ADDRESS: <br />���t��� <br />,�.j RERTY TAX k f <br />�� �-/ � f ;d( ? t-1 .� cf l <br /># <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER �,� V� ��L�-j �� Phone/E-mail u 1 � -�J {''i �',-� %) �� � .` <br />PPLICANT: � Owner _ Owner's Agent _ Contractor <br />ONTRACTOR ���.,A�)V\'t2�J� <br />ress <br />BUILDING PERMIT APPLICATION <br />�City/State/Zip r l�� L'Li� � �,r? � � <br />COIlYf2CtOf�S fiCJ2flt _ T2ft2fli (must provide a letter of consent from the owner to do work in the space) <br />State Lic. # City Bus. Lic. # <br />Phone/Email <br />CONTACT F�R PER� <br />�'J6 J�� �.J U� �-I �' S L'u-��' �`� C� S ��'�L}���� <br />Phone/E-mail (�(1 j � � C G'a'ti-Z �� � -� �j�' <br />CONTRACT PRICE OF WORK � ) �C�< �� ���5 <br />Existing Use of Building E� � � ��-� �.� ��� �� <br />Proposed Use of Building (i� G{ ��� ��� ��� X-E-vr�' Gas_ <br />Building type: _ Single Family _ Duplex _Townhouse--� Multi-Family _ Commercial <br />Type of project: New Addition Remodel � Repair _ T.I. _ Sign _Sprinkler De <br />DESCRIPTION QF WORK (additiona/ space provided on the back) :�/ p�� � �l`�`' �l !J�(�.' <br />r�� � ��� � vI- �/�,: � �.,�-- Th.r, (� �- ,�.�:+c�n 5 �� L <br />�"tO�- re�I<<c�'�� -�-v: (�-F i Shaw-�,- �-�--�U V- k����S��� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />j A/C - air handling units <br />I Forced air systems <br />I Water heater <br />Gas fireplace <br />i Gas range <br />Clothes dryer <br />Rangehood <br />j Exhaust fan <br />( Heat pump <br />i Unit heater <br />� Boiler <br />I Refrigeration <br />Woodstove <br />Ducting <br />j Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />Other <br />molition Change of Use <br />Cj 0 u% � � j L.C� v', tJ � l�t' �- <br />PLUMBING PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration �Repair <br />Show Number (#) of fixtures <br />,� ; Toilet �! / U�� - / <br />� Bathtub <br />� Lavatory (wash basin) i <br />� i snower � j j„1 - <br />�2; Kitchen sink & d�se� jQ� <br />, Dishwasher <br />c;iotnes wasner <br />Water heater ; <br />Sink (service/bar/m <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />-r / <br />G <br />, �`/OS`, <br />,c�'`';c� <br />�� _ /��1 <br />I hereby certify that I have read and examined this application and know the same lo 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 periorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />- �z� _ �%%� <br />S� <br />Owne� u orized Age t Signature Date (Revised 3/2013) <br />