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PERMIT APPLICATION <br />BUILDIIVG/MECHANICAL/PLUMBING/SIGN/St RINKLER/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 />'E ADDRESS: <br />' �i �✓ � r � �'ur G fv �i �r�•`r � <br />3AL for new construction: Short PlaUsubdivision <br />-, <br />INER 1.�v,+�c � /'t�,�C�-,r�� l�t <br />idress <br />PPLICANT: <br />ONTRACTOR <br />�dress <br />Owner _ Owner's Agent <br />� r-,� � v� C_.--�t r� � S i <br />� �� �l ����)�1', %F►�.. ) ?i�� <br />PROPERTY TAX # P ,RIVL�T #, 1 <br />f l.�iL 'Uy X�� G'd5 �'i�oc? ��'?�J ��•-�J(-7� <br />e--� <br />Lot No. (attach copy of long legal description) <br />,� Phone/E-mail <br />City/State/Zip �y.-r,-,C.,,✓�!%r-Ct �/ �-,,�' � <br />COf1tfBClOf _ COf1lf8CfOf�S A9Bllt _ T01lTfll (must provide a letter of consent from the owner to do work in the space) <br />;,� State Lic. #Gi/�r�� c•. �� ,1/G City Bus. Lic. # <br />�; � ��( �) Fhone/Emaii <br />CONTACT FOR PERMIT .���,,,� �(,� r,5,�,,:,,,,�, - <br />� � � �- <br />Phone/E-mail � ,`� �� � � -' � �_ r � ' <br />��� <br />BUILDING PERMIT APPLICATION CONTRACT PRIvE OF WORK I`:- �- _% <br />Existing Use of Building ��f� %L--� <br />i; <br />Proposed Use of Building S�<�"� <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family <br />Type of project: New Addition Remodel _ Repair _ T.I. _ <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />,� -�,, iTi �-� i%i�'�r i rc . , r� -� r�%t-- �`" r F ,.l <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 />j Water heater <br />Gas fireplace <br />� Gas range <br />Clothes dryer <br />( Range hood <br />Exhaust fan <br />Heat pump <br />�, I Unit heater <br />� Boiler <br />Refrigeration <br />Woodstove <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />Gas Electric ✓ Ot <br />Commercial <br />Sprinkler Demclition Change of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New �''�Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� <br />� <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <br />Urinal <br />Drinking Founta�n <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 lrue and correct. All provisions of laws and ordinances governing this type of work will ba complied <br />with whether specified herein or not. The granting of a permil does not presume to give aulhority to violate or cancel the provision of any other state or local law regulating construction <br />That I am authorized by the owner uf this property to perform the work for which application is made and I comply with the Slate Contractors Law 18.27 RC W and 296200A �iVAC. t <br />- - I�_" <br />�`� c L � ; � <br />, � � +_ <br />Owner/Authorized A�nt gnature Date (Revised 3/2013) <br />