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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 />SITE ADDRESS: .. <br />�'a5 rrL <br />LEGAL for new construction: Short PlaUsubdivisio <br />vvrvcK �o� r�i� A-N <br />idress �%G` ( f���� S <br />PPLICANT: _ Owner � <br />CONTRACTOR .� 7` c��;�5 <br />ERTY TAX 4t <br />Lot No. (attach copy of long legal description) <br />DOi�C-� VC>t�[�E(� � <br />•�95 /�-,E.N'T' Phone/E-mail � Vc� ��c (' �'� � r��5�� f : C-u� <br />T- �` %�j 7 5 I City/State/Zip SE.�T T � E W i�- `� �j 1' O% <br />OW f1ef�S A9@fl� _ COIlif2Ci0f _ COIlffBCtOf�S AQBfII _ T011211f (must provide a letle� of consent from the owner to do wo�k in the space) <br />/1 �c"> 11- <br />State Lic. # <br />Citv Bus. Lic. # <br />L`�i,✓,l� 3• j�Fi'7"�•� � IPhone/Email Z. �- �- %� �. 1�• c`C <br />CONTACT FOR PERMIT /2 -�, Z� b <br />t <br />!"v!i P� 3��-�-� �Pf1-;�-r��;�;-r5 <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ <br />Type of project: New Addition Remodel Repair <br />DESCRIPTION OF WORK (additiona/ space provided on the back) : <br />QE S T(� l r� C t�F)- �L !G /� C� L-o 'r To <br />l �.. . i r ��_ .. . " " ... .. , - ' � . <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show NumBer (#) of fixtures <br />� A/C - air handling units <br />I Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />� Gas range <br />I Clothes dryer <br />Rangehood <br />� Exhaust fan <br />� Heat pump <br />i Unit heater <br />� Boiler <br />; Refrigeration <br />Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />U � Y - (o �' i <br />Phone/E-mail ������'� � Cf ��i 5���: ca.✓� <br />CONTRACT PRICE OF WORK � 1.35� <br />HEAT SOURCE: <br />Gas Electric Other <br />Multi-Family _ Commercial <br />T.I. Siqn Sprinkler Demolition Chanae of Use <br />C� i 7�c Cr- -tr� �f-e �1: �- _. E'L � S�' � i t. � <br />I ^I ` 7 ^ . � (`� �J. <br />�� <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 />j Shower <br />� Kitchen sink & disposal <br />, Dishwasher <br />�iotnes wasner <br />Water heater <br />Sink (service/bar/m <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 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 pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RC W and 296.200A WAC. � <br />\ � <br />� � � i" <br />Owner uthorized Agent Signature ate (Revised 3/2013) <br />