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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/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 />SI ADDRESS: IPROPERTY TAX p I PERMIT # <br />� � � 1 o s-�'�' ��. SE � ,� ti � � p . <br />LEGAL for new conslruction: Short PlaVsubdivision Lot No. (attach copy of long legal description) <br />OWNER bI -�, -�r m Qr 0 V t 1� �� �- �L. \C�an� S PhonelE-mail �aJ '�-5 �' O�%�2v <br />� <br />_ Owner _ Owners Agent <br />UILDING PERMIT APPLICATION <br />_ Contraclors Agent <br />State Lic. # <br />T0tI0f1l (rtpul provMe e letter ot coneenl from the owner to do v.ork in the sw <br />�q�-� � ��ty BUS. ���. � da $ a <br />ione/Email ��p • a � � ' � �� <br />t PERMIT � m� t �y1�ri�.�r1 <br />� ti ou m�� -��! <br />f PRICE OF WORK <br />Existing Use of Building � <br />Proposed Use of Buildinp <br />Building type: �gie Family _ Duplex _Townhouse _ Multi�-Family _ Commercial <br />Type of project: New Addilion Remodel Repair '�T.i. Sign Sprinkle <br />DE� R�PTION OF� K fa�drrro�er sPace rovided on the back) :� <br />� '�V��l t�k�� S 3 �t' � <br />MECHANIGAL PERMIT APPLICATION <br />of Project: _New _Addn L/Alteratton _Repalr <br />Show Number # of ftntu►es <br />AIC — air handlina units <br />Gas piping <br />Water heater <br />Range hood <br />Exhaust fa� <br />on <br />SPRINKLER ! SUPPRESSION <br />HEAT SOURCE: <br />of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteratfon _Rapair <br />Show Number !t!) o/ Rxtures <br />Lavatory (wash bz <br />Shower <br />Kitchen sink � dis <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (servicelbarli <br />Backflow prevente <br />Urinal <br />Drinkinq Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />� � Number of Heads I 1 I v���tl�. <br />I hereby ceRify that I heve read and e�minetl this applicalion and know the sema to be Irue and cortect. All provisions of laws and ordinances goveming thls rype of work wtll be comp <br />' whether specffied herein or not. The grenting of a permil does �ot presume to give autharity to vlolale or rancel the provLsion of any other slate or Iacel law regulaUng construclion <br />The I em aulho�zed by the own r ot this propeRy to perfortn Ihe work for eh eppli t'an is made and I comply with Ihe Stele ConUactors Lew 18.27 RCW and 296.200A WAC. <br />' 1 � � � (Revised 9/2014) <br />nerlAuthonzed Agent Signature a�e <br />