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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: PROPERTY TAX # P RMIT # <br />i�2-I ► ��� �,-� ��� ,� �o�� qo� 4-�► i�v 0 ��� u 3 r�� e�JF <br />for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />� <br />_ Owner � Owner's Agent _ Contractor <br />Phone/E-mail 6�'2'�j �Ze�j� — <br />�City/State/Zip ����� � �� ��j�J��'� <br />Contractor�S A9211t _ T@f12f1� (must provide a lelter ot consent from lhe ownar lo do work in lhe spaca) <br />NTRACTOR "'l()',� ��} (,1 i5 �(� / f�(LCL(�YC- �L & I Lic. # <br />ress � d � (� C �� � �� G��ST :�� Z�C� <br />�ANT BUSINESS NAME �'_ �/ev�y ��p� �� fJ-� CONTACT <br />"�' - � �: ��l=�bi� C� � �G�l'� �-,l -� Phone/E-mail <br />COE Bus. Lic. # <br />�►��'VLL �iI�CX�'�'j'1 <br />�Z�J �; !,v'(D �-tv� X; f [4� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �-C !, Z 00 <br />Existing Use of Building 9 4� g� 511�Ct S HEAT SOURCE: <br />Proposed Use of Building Iv� (�CftiCi�lLl�i Gas_ Electric_ � <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family � Commercial <br />Type of project: New Addition Remodel Repair T.I. _ Sign _5prinkler _Demolition_Change <br />DESCRIPTION OF WORK (additional space rovided on the back)' <br />of Use <br />"t r.t�kN,`� iM. P"��-I �t.i � �Pc � i�'�—� �.�.�� � t�v� tt �h1�i � l��Tt2� �� � �� d.11� <br />�( IW'P 1� � �r �tT� <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of �xtures <br />A!C - air handlina units <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 />� Woodstove <br />Ducting <br />Other <br />KLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of f/xtures <br />Lavatory (wash basin <br />Shower <br />Kitchen sink & dispo: <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/moF <br />Backflow preventer <br />Urinal <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 specifed herein or noL The granting of a permil does not presume to give authority to violate or cancel the provision of any other state or local law regulating construc[ion <br />That I am authorized by the owner of this property to perform [he work for which applicatlon is made and I comply with the State ConVactors Law 18.27 RCW and 296200A WAC. <br />ll� <br />/YY� �` . �, , <br />ner uthorized Agent igna re ate (Revised 6/2012) <br />