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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />E ADDRESS: ? PROPERTY TAX # PEWpVIIT �#) <br />, ('1� �� 3;"a� .`, � :� � �iJ.LY2.��1' �c � �1� (jf�e!' 3�� ' � � I _ � 1 � C � ���•� L � � `7 (� � ' � "� %�. <br />/ <br />iAL for new construction: Short Plat/subdivision Lot No/C, � � (attach copy of long legal description) <br />'NER 6i(,�,� 1`�i1�-.7�` � Phone/E-mail �`.)✓ ��2 - %��'�� <br />�ess %�. n i �) j'=A S��' S� F CitylState/Zip ,�,-c }�J- �%,�� 7 Y Z�� <br />�LICANT: _ Owner _ Owner's Agent ��- Contractor _ Contractor�S Ag@!li _ T2f18f1Y (must provide a letter of consent from the owner to do work in the space) <br />NTRACTOR ��Z�/►'��� �'�r+�i (_�.•�}rh`.����, L& I lic. #NI2�iW��- j3S�� COE Bus. Lic. # <br />ressrb`�l� �%'�!1✓L i,,a1 L.�qr�v,L1;,=�,,� L�r;V '�f�`' � Phone/Email ��G�'„�`��� ' y,y/ <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: '� Single Family _ Duplex _Townhouse _ Multi-Family <br />Type of project: New ;� Addition Remodel Repair _ T.I. <br />DESCRIPTION OF WORK (additiona� space provided on the back) : <br />�,;�w r��-�: t���=9 ����:,�K- <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C - air handling units <br />Forced air systems <br />`� ' Gas pipina <br />Liotnes aryer <br />Range hood <br />Exhaustfan <br />at pump <br />Urn heater <br />Boiler <br />Refri er ion <br />Woodstov <br />Ducting <br />Other <br />�SUPPRESS N SYSTEM <br />Number of Heads <br />FOR PERMIT �-T �� <br />�� �j'Z�-.��'�' �I"�`l/ <br />T PRICE OF WORK ��, C"='�' ``` <br />HEAT SOURCE: <br />Commercial <br />Sprinkler Demolition Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixiures <br />Toilet <br />'� Bathtub <br />, Lavatorv (wash basin) <br />Shower <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/b� <br />Urinal <br />Drinkin Fountain <br />Floor drai <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 correcf. All provisions of laws and ordinances governing this type of work will be complied <br />wiih whether speci(ed herein or not. The granting of a permit does not presume to give authority lo violate or cancel the provision of any other state or local law reg�lating consWction <br />That I am authorized by the owner of lhis p perty to perform the work for which application is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. <br />,� � ,. ` I Z <br />,,,rry . .Z <br />Odvner/Authoriz Agent Signature Date (Revised 6/2012) <br />