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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 />SITE ADDRESS: r PROPERTY TAX # P RMIT # <br />1�2� /�Z�- Sf �c 2svSi�6O s�o�ood �'I�i(�-�'C�C <br />LEGAL for new construction: Short PlaUsubdivision <br />OWNER �pSe.v� P�Pc✓�-�, e � <br />❑r <br />APPLICANT: _ Owner _ Owner's Agent � Contractor <br />CONTRACTOR / '��l_ K/%.�.,r.C„��n._ % � <br />ss <br />� ws �'aa v-� <br />BUILDING PERMIT APPLI ATION <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail ��" � '�' �,"� lf2.� % Z�^7 —Z2S <br />City/State/Zip ��`/{ �/ <br />COf1tf8C10f S f192f1Y _ T2f1Bll� (must provide a lelter of consent from the owner to do work in the space) <br />L8�ILic.# <br />COE Bus. Lic. # <br />,�lG ��Z %/ Phone/Email 3(p0 — Co G / — ��(a � <br />CONTACT F R PE�MIT � <br />p� �,pu-.�%. <br />�� <br />Phone/E-mail p„�.y.� �L Q (� %,E,�„ , �i <br />CONTRACT PRICE OF WORK 3�Ov "' <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family �C Commercial <br />Type of project: New Addition Remodel Repair � T.I. _ Sign _Sprinkler _ <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />��� �� ��� C'�a�,�_._ ��` ��� o� oH..� <br />' v � c,�a.�-�.� Ll �-�— <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of /ixtures <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 />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />Other <br />' SUPPRESSION <br />Number of Heads <br />HEAT SOURCE: <br />Gas Electric Other <br />Demolition Change of Use <br />�'6� l�,�- ow�-- ��'v <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Num6er (#) of fixtures <br />� Toilet <br />Bathtub <br />rvtcnen sinK r� ais <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/ <br />Backflow preventE <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby ceRify 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 violale or cancel the provision of any other state or local law regulating conslruclion <br />That I am authorized by the wner of this property to perform the work for which applicalion is made and I comply with lhe State Contractors Law 1827 RCW and 296.200A WAC. <br />i <br />i <br />�'. �-2� /.� <br />Owner/A orized Agent Signature Date (Revised 6/2012) <br />