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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 P�3� 0` OD�j <br />E ADDRESS: ,,� � — PROPERTY TA�.# P MIT # <br />,�� �a2.t�, ��- `,� ��:��- c.- �;�cs I Jl����1C l�"�. C r� i�,�� —�!q <br />for new construction: Short Plat/subdivisi <br />ER K��S� ;, � <br />No. (attach copy of long legal description) <br />t�j Phone/E-mail l27 ' 2L� ( - ��.j�� <br />City/State/Zip �/l��;j,� /�;� � <br />APPLICANT: _ Owner _ Owner's Agent x Contractor <br />CONTRACTOR i%�'tti� f}���(1�'� <<r�C� C'a�ii��' <br />Address ����. ��X •j1_L5, ht✓.�!iC;rti�� �tdi- �� <br />!�m'cl��' j f� ��'C;` � (1� <br />� <br />BUILDING PERMIT APPLICATION <br />COI1tfaCiOf'S i1gBIlY _ Tef18(lf (must provitle a letter of consent from the owner to clo work in the space) <br />L& I Lic. # L't �`�'JKFI-%C `1 ����". j] COE Bus. Lic. # <br />� , , � -, <br />���'�'_� PhonelEmail`�"l�'�l/-/2l3��1�'��� �-'["r��'��1�'�`�'�Z <br />CONTACT FOR PERMIT) l ��l�y , �(�.� �'�;`, <br />Phone/E-mail %LS _� L.1 � l2°�,,�v/� ir'ihyC�- �'� �l -f7G'v'IC � CG`.,'L"J <br />CONTRACT PRICE OF WORK J`� CL�f.� <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas X Elect� <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family f� Commercial <br />Type of project: _ New _ Addition _ Remodel _ Repair ;� T.I. _ Sign _Sprinkler _Demolition <br />DESCRIPTION OF WORK (additional space provided on t��e back) :�"� ��c7 � � �u�'..��,r �( �'y'L/ c�,��l (�� �G <br />,�C �;�,�� ,�X�edu) �'-r;�s�`r� ��c.7 I;ne -1�� �c��nrc�- ��c r��� �1�� � �ni i- � R�e�Y acicl 1 <br />, <br />�hh<i�; �- -���.,�� � <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 piping <br />Water heater <br />' Gas fireplace <br />Gas range <br />Clothes drver <br />I <br />I <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeratio <br />Woodstove <br />Other <br />PRINKLER / SUPPRE!SSION SYSTEM <br />' Number of Heads <br />Change of Use <br />����5+r� (o[��P <br />riz�:.- (�� f �'C�ry� � <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fixtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />' Water heater <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 applica�ion and know the same to be irue and correcL All provisions of laws and ordinances goveminy �his type of work will be complied <br />with whether specified herein or noL 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 consVuction <br />That I am a�rthorized by the owner of ihis property to perform tlie work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br />�/ <br />� � �'. L <br />t-�-� <br />/-� <C r <br />ner/ jathor,ized Agent Signature Date (Revised 6/2012) <br />�� <br />