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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SI�N/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 />ITE ADDRES$ <br />4h t r�� r� <br />PROPERTY TAX # <br />I2� v <br />EGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER � p�� O � �-�r- Phone/E-mail 3�f"~21�5'' <br />Address L =.j s�f- 5� City/State/Zip �j�P�� ti � /8Z <br />APPUCANT: _ Owner _ Owner's Agent X Contractor _ Contractor�S A9@I1t _ TBfl2flf (must provide a letter of consenl from the owner to do work in the space) <br />CONTRACTOR /{'/�� oNS�YUC�I��n B,Solj(��t StateLic.# ��Qr� QQS'q�1Z CityBus.Lic.#O!S/'�`� <br />, <br />� n r s o.,. �-E <br />T <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: i� Single Family _ Duplex _Townhouse _ <br />Type of project: New Addition Remodel � Repair <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�ruSS rC�t4 Y a� G-b.o � r� G 6� r��e o.� <br />MECHANICAL PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteretion _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />I Forced air systems <br />Gas piping <br />i Water heater <br />j Gas fireplace <br />i Gas range <br />! Clothes dryer <br />1 Range hood <br />j Exhaust fan <br />� Heat pump <br />� Unit heater <br />Boiler <br />� Refrigeration <br />; Woodstove <br />� Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />( Number of Heads <br />� IPhone/Einail ��Q6 3((0 • �(a <br />CONTACT FOR PERMIT � <br />�one/E-mail <br />ONTRACT PRICE OF WORK <br />Multi-Family _ Commercial <br />T.I. Siqn Sprinkler <br />VQG !` iJ � �OP T , <br />HEAT SOURCE: <br />Electric Other� <br />molition Chanpe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <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/e <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 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 complicd <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 construrtion <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 Contractors Law 18.27 RCW and 296.200A WAC. <br />Ow e Authoriz Agent Signature ate (Revised 3/2013) <br />