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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 />ITE ADDRESS: PROPERTY TAX # PERMIT � <br />i�i -� � :, ���IC1 � 1 "? �' _ i� ._.,e�r.., , � ►I 1�� ~: /�r <br />for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />2 � � , v ,'1 ' Phone/E-mail � —�� t �}� � <br />i� � % �3 � �C �C'1`��� �t �r\� N � : _. z-� 'l� �i YIi�.li{ City/State/Zip ��_I ( � v .' , .0 i , `, ,�, �� �'�� <br />Owner _ Owner's Agent � Contractor <br />NTRACTOR <br />� :��- ��r= .,�1( F� ��f �Il.��r S ; <br />.. -1 <br />'�J �:�.;''����� �� a> [� ��� <br />BUILDING PERMIT APPLICATION <br />COf1tf2Ci0iS fi92fli _ T@fl8fll (must provide a letter of wnsent from the ovmer to do work in ihe space) <br />L& I Lic. #,_Z�� y,qr�;�,1'�'" �{ ��1� COE Bus. Lic. # <br />� Phone/Email • ' ,"i` —1 ] ' ' � <br />CONTACT FOR PERMIT'� - ' e - � <br />`f;% S - `7�J. —� i'; 'ie� 4liia�-�i �"1`J��l <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Fam <br />Type of project: New Addition Remodel Repair _ T.I. y <br />DESCRIPTION OF WORK (additional space provided on the 6ack) : <br />� � <br />� I1c1 I�, � {'c �'� `� � ? ��� � ��0 ►� <br />1 � <br />MECHANICAL PERMIT APPLICATION � <br />of Project: _New _Addn _Alteration _Repair <br />Show Num6er (#) of fi�riures <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas range <br />Clothes drye <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />/ SUPPRESS <br />Number of Heads <br />PRICE OF <br />Commercial <br />Sprinkler <br />HEAT SOURCE: <br />Electric Other <br />of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#1 of �xtures <br />Bathtub <br />Lavatory (wash b< <br />Shower <br />Kitchen sink & dis <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/barl <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 certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this type of work will be complied <br />with whether specified herein or not. The granting of a permit does not presume to give authoriry to violate or cancel the provision of any olher state or local law regulating construction <br />That I am authorized by the owner of this property to perform the work for which application is made and 1 comply wilh the State Contractors Law 18.27 RCW and 296200A WAC. <br />� i� <br />✓ c�l��.�"" � �- �� � j���� <br />, O ner horized Agent Signature Date (Revised 6/2012) <br />, ! <br />`�"�%i- <br />