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L�l � /Z -U`'�. <br />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 />'d �,7. "� I12� S <br />.+�; <br />IPROPERTY TAX q <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER <br />Address <br />Phone/E-mail <br />City/State/Zip <br />� <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor's Agent _ Tenant �m�5i provide a ieuer ot con5enc rrom �ne owner io do work �n �ne sPace� <br />CONTRACTOR �1 <br />Adaress <br />TENANT <br />BUILDING PERMIT APPLICATION <br />Existing Use of Buiiding <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ <br />Type of project: New Addition Remodel _ Repair <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />/�-�cQ l�-�l� Qfs,1--r�v�.i.. -j�o v'a�.�.�✓�' <br />}� � t,� � yk C��f' S,. �L �. � �s..� lc.�-41t� S..-.�,� <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 />I Gas ranae <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refriaeration <br />� Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />State Lic. # <br />Bus. Lic. # <br />Phone/Email ��� �- �,,(sf',��5 <br />R PERMIT <br />� ��� �✓ vt� � � G, /�.�luK,/a.�� .>�� <br />Phone/E-mail J <br />«� <br />CONTRACT PRICE OF WORK 5 Z�� " <br />HEAT SOURCE: <br />Multi-Family _ Commercial <br />T.I. Siqn Sprinkler _ Demol <br />s ��- �--�- <br />� ;;�,�..h 11 i � c;: t. �. <br />� <br />Other <br />Change of Use <br />�v �r i�s � <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />'2, � Lavatory (wash basin) <br />I Shower <br />; Kitchen sink & disposal <br />i Dishwasher <br />; Clothes washer <br />Water heater <br />; Sink (service/bar/mop/etc.) <br />I Backflow nreventer <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 granling of a permit does nol presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I am authorize�l�y-{ owner of this property to periorm the work for which application is made and I comply with the State Conlractors Law 18.27 RCW and 296.200A WAC. <br />.. <br />i <br />/ /C.i � � �i� � /� <br />Owner/ thorize AgentSignature Date (Revised3/2013) <br />