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� • <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 DRESS: PROPERTYTAX# PERMIT <br />� 3c`� ���ri�E��i ��-�r��Ti N1�c.� w� ' � i�0 <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />owNER i<CUJ Rc;31/'� G������c7 ��/'�-C-KS Pno�e�E-ma�� :3G �—� y�, �-�,Ooc:� <br />ndd�ess � 31Z ����OL�� S(sl'�C.�I� CI �Z`'�%� c�riistateiz�P ��FE�v t,��c �� V i�c./�L L. C�; < <br />'LICANT: _ Owner <br />NTRACTOR � C� <br />� Owner's Agent _ Contractor <br />���/N 1 � �� V� � <br />�e��, ��bi� <br />BUILDING PERMIT APPLICATION <br />-043 <br />��r <br />COf1t�8CiOf S A92f1[ _ TB�8f1Y (must provide a letter of consent from the ovmer to do work in the <br />1,�� State Lic. # Jf'/G'�/�IL- V vV" I�Z� x:�rY Bus. Lic. #�I�� <br />Phone/E-mail <br />CONTRACT PRICE OF WORK <br />Existing Use of Building �; " L � I'�C-)�3`=1 "d�%`-�iV-T ri HEAT SOURCE: <br />Proposed Use of Building Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family ,�Commercial <br />Type of project: New Addition �Remodel Repair �T.I. _ Sign _Sprinkler _Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�'-�cc.�v��S �� Di�lnlc; ArE/+.�--w��,�.��.����T —o a��� ���s����— ��EsT�,��,�-�•�� . 7��� ���S���c- <br />� � � <br />i>v�c�WG- E,,)� tL��f'C i,vlC.c._ �E/�0-I f�)_ <�JEw �lG-I-I i/rJL- ;'A�I<✓-I�-1 �IlCL 1�(- I�S� WC�t� %t;Jn �ir�c�t <br />S�'�=�( T��,^.i� TJL �^' �`'�° .v���.,�C= �/=�� 0,2 �I�JIS�/� � A��i� I'/-� I�J j ��G R��r� )'^�I�� �i � l,�C��i)��_ <br />r� � I C-.,,':=I7/G: J' /J"i �=���� �"'ti�� N� X�c� ///E'Lf�%., <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair Type of Project: _New _Addn �Alteration _Repair <br />Show Number #) of fixiures Show Number #) of fixtures <br />A/C - air handlin units Toilet <br />Forced air svstems \ Bathtub <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust farn. <br />Heat pump <br />Boiler <br />Woodstove <br />Ductin <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />basin <br />sink & <br />Dishwasher <br />Clothe� <br />Water heatet•, <br />Backflow preventi <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 compl <br />with whether specified here�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 regulating construction <br />That I am authorized by2F�e-owner of this pro ert tp.p�rform the work for which a plication is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. <br />, �--"' <br />�---Z--� ` `� 2 Z l <br />OwnerlAuthorized Agent Signature ---' - D e � (Revised 9/2014) <br />c... <br />[ % ,� <br />v"� <br />