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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 />E ADDRESS: PROPERTY TAX # <br />��' �' ,� �J_ ��n i\�11�i '� \! f 1= i� �)�' �.�10'i I�> <br />3AL for new construction: Short PlaUsubdivision Lot No. <br />NER ��l �; Y��.� �� Phone/E-mail �� <br />� � . t'11 <br />ress � �-�. �_ � � — � I �j („i City/State/Zip <br />PLICANT: �Owner _ Owner's Agent _ Contractor <br />CONTRACTOR <br />BUILDING PERMIT APPLICATION <br />P M�T # .,� <br />i�� ,3(_> I � C � �� � "' � �i' {� � <br />_(attach copy of long legal description) <br />� �7�;���'-i3��-� ������I I��n�h��i.�1�s��,;��,�vr�,���� <br />�l_a.l-T L%� �i;��;�,, <br />COIltf2CtO��S AgEllt _ T@fl8flt (must provide a lelter of consent from the owner to do work in the space) <br />State Lic. # <br />Phone/Email <br />�%� �l L3l�,nc�.��c' <br />�ne/E-mail !-.) � S 7 <br />)NTRACT PRICE OF WORK <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition Remodel Repair _ T.I. Sign _Sprinkler <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />— f;►� a►–ac.F��� �=i��,— (;'i= r X15�i ii�t 1:- F�(;CK� �ri����!%�'-1 L <br />w; i j I�� 1�l f� �1 �1(�Li�j � i i, L i v�v�L i�l l� i- 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 />� Water heater <br />� Gas fireplace <br />� Gas range <br />� Clothes dryer <br />� Rangehood <br />� Exhaustfan <br />� Heat pump <br />Boiler <br />Refrigeration <br />Woodstove <br />Ductinq <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />City Bus. Lic. # '(� � <br />� -�--l30 3 lJr�f3�-Ahlc.N <br />HEAT SOURCE: <br />Electric Other <br />of Use <br />I,J �� L L <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 />( Shower <br />� Kitchen sink & disposal <br />� Dishwasher <br />� Clothes washer <br />� Water heater <br />� Sink (service/bar/mop/etc.) <br />� Backflow preventer <br />� Urinal <br />� Drinking Fountain <br />� Floor drain <br />� Grease trap <br />� Roof drains <br />I Medical Gas <br />IOther: <br />IOther: <br />I hereby certify that I have reyd d examined this application and know the same to be true and correct. All provisions of laws and ordinances goveming this fype of work will be comp <br />with whether specifie he�ein o not. The graniing of a permit does n resume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I am authori d by the ner of t s pro rty to perforjn the w� for which application is made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. <br />/ <br />Sign�fure `� � � Date <br />(Revised 9/2014) <br />Nv q,�u <br />LO"�%1 <br />