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ERMIT APPLICATIO <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: PROPERTY TAX # PERMIT # _� .� <br />�:i " l/� ��� ��� � �C� �(�='(c=� r�� 1 `'�(� — � l�.-) <br />.y <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />OWNER � �-� C' , -�G� � ' " �j Phone/E-mail i1 G � f� � E'r/i�5 � �� `l�l � t-��; �f�21 <br />� <br />add�ess �;`� /S 15 / H G'�- � �SC_ c�tyistateiz�p �y2�� . iz:;,5 ��r �z�',•=� ���Z � , <br />PLICANT: �wner <br />ONTRACTOR <br />Owner's Agent _ Contractor _ Contractor�5 Ag01lf _ TEf18f1Y (must provide a lelter of consent from the owner to do work in Ihe space) <br />�a v � � �� �C, <br />BUILDING PERMIT APPLICATION <br />State Lic. # <br />Phone/Email <br />�{Z j Z. 3 �' .c� �Sj 5 <br />Bus. Lic. # <br />'v� `�C`-' ����' E' C <br />T PRICE OF WORK �% C'Q <br />Existing Use of Building � �tii.-c.0 _ � <br />Proposed Use of Building �E_ � C�� <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family /i�ommercial <br />Type of project: New Addition Remodel Repair _ T.I. _ Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />� <br />) 1`( �'�i�,�k G�Cz-� �,�l c�c���, �z '' X �✓ -�;,� rt i` fi� 1J � <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I A/C – air handling units <br />� Forced air systems <br />Gas piping <br />j Water heater <br />j Gas fireplace <br />I Gas range <br />� Clothes dryer <br />� Range hood <br />�—� Exhaust fan <br />Heat pump <br />; Unit heater <br />! Boiler <br />� Woodstove <br />I Ducting <br />j Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />HEAT SOURCE: <br />_ Electric �/ Other_ <br />molition Change of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />! Toilet <br />; Bathtub <br />� Lavatory (wash basin) <br />j Shower <br />� Kitchen sink & disposal <br />� Dishwasher <br />� Clothes washer <br />i Water heater <br />I Sink (service/bar/mop/etc.) <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 correcl. All provisions of laws and ordinances governing lhis 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 violate or cancel the provision of any other state or local law regulafing construction <br />That I am authorized by the owner o,f.this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />�� � �� , ; <br />, � , �--- <br />� � ���� � �� � <br />Owner/Authorized Agent Signa re ' Date (Revised 3/2013) <br />