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I'ERMIT 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�1: //�,� `� /I I��i,� �J' "t 5 �_ �'I <br />Ct/c�it�t�' I'1' �.,�!' 1 y`(5� i�`?i <br />LEGAL for new construction: Short PlaVsubdivision <br />OWNER J ' ��� �c�d � � ' <br />Address � `�;��C � `�—� � <br />APPLICANT: _ Owner _ Owner's Agent �ontractor _ <br />CONTRACTOR �"� /� ��j t� ✓ C�'��'�►`li` � i"� �� <br />Address ✓5�� )'�<r�.�J���,� ,�r �-hhv��-.��oc�I <br />TEN NT BUSINESS NAME <br />lI ��-��� <br />BUILDING PERMIT APPLICATION <br />ERTY TAX # <br />y <br />P�a�T'��l�S UC 7 <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail �1 ��J ` ys �/— �� �� <br />ICity/State/Zipr��'r�L� io ��� �'��`7�y <br />Contractor�S A90flt _ T0118�t (musl provide a letter of consent from �he owner lo do work in the space) <br />State Lic. # � l ���n���' �'�3,(�(�City Bus. Lic. #_ _ <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 />D�FS�RIPTIOy OF WORK (additional space provided on the back) : <br />�v �;'v,,l�t''�� <br />V` <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />� Forced air systems <br />� Gas piping <br />� Water heater <br />� Gas fireplace <br />� Gas range <br />� Clothes dryer <br />� Range hood <br />Exhaust fan <br />Heat pump <br />� Unit heater <br />i Boiler <br />� Refrigeration <br />� Woodstove <br />� Ducting <br />� Other <br />SPRINKLER / SUPPRESSIOI�I Sl(SiEfVi <br />� Number of Heads <br />b� ��� Phone/Email �p2'j � <br />CONTACT FiOR/,�'E,RMIT <br />',.1/� � ,}- -t !it � a�,5� ,.. <br />Phone/E-mail Q' �' ,� -i � <br />CONTRACT PRICE OF WO <br />7yl-�l� <br />���� 7 `��'�5 /C% <br />'t"3cv C t� ln �: ��v� i.� ,� f. �.. :n .. c <br />HEAT SOURCE: <br />Gas Electric Other <br />Multi-Family %LCommercial <br />��.I..;� Sign _Sprinkler _Demolition_Change of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />i Toilet <br />� Bathtub <br />� Lavatory (wash basin) <br />� Shower <br />� Kitchen sink & disposal <br />i Dishwasher <br />� Clothes washer <br />� Water heater <br />� Sink (service/bar/mop/etc.) <br />� Backflow preventer <br />� Urinal <br />j Drinking Fountain <br />� Floor drain <br />( Grease trap <br />� Roof drains <br />I Medical Gas <br />IOther: <br />� Other: <br />I nereby certify lhat I have read and examined this application and know the same to be lrue 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 slate or local law regulating construction <br />That I am authorized by ihe owner of this property to perform the work for which appiication is made and I comply with the State CoNractors Law 18.27 RCW and 296200A WAC. <br />� /� <br />rlAu ' ed Agent Signature ate (Revised 3/2013) <br />