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�ERMIT APPLICATI� <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINI�LER/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: � 2 _� � , , , � PROPERTY TAX # /� P,�RMIT # <br />�{ � >_�_ � E G� �E' 14�; G7J f �r. ���C_ C .j �� �J S S �� GC%�V C�/ � �> l� C� `� �C�-��� , � � �"�I ) � <br />LEGAL for new construction: Short Plat/subdivision�� �e �'-� � t/� v�� Lot No. ����� (attach c��py of long legal description) V�'�;, �� <br />� Cd l"✓! �'S <� %��« !'� �� C'G�i t' i�' Phone/E-mail <br />�� y% 7 ��lG�! P l 1� 071 f D,/'. City/State/Zip <br />�NT: _ Owner � Owner's Agent _ Contractor _ Contractor's Agent <br />ONTRACTOR <br />State Lic. # <br />ON <br />onelE-mail <br />��� . %S �� �'���� l ii�`,' CG�i'iP� ✓ �S ��"'J� <br />_ � �� �, ��� <br />�����tf, �,�� `�8"� c� � � <br />T2f12t1t (must provide a letter of consent from the owner to do work in the space) <br />City Bus. Lic. # <br />Phone/Email L�/IYi��il�ivt�lf✓��i�/ISI,�G�✓�C'f •� <br />)R PERMIT � <br />��l �/ Sf/ %`� li ��Tc�����[ �l'��'r C� <br />_� � �, � c� � ��� � <br />BUILDING PERMIT APPLICATION CONrRacr PRICE oF woRM_ +S`1��, Cr'�� <br />Existing Use of Building _?i.^ � L�, �� C�� c� � l—� ���= � t��L'_ HEAT SOURCE: <br />i <br />PI'oposed Use of Building %���l i_�' -�� t � i i. �, f-i7 �,i j�_ Gas� Electric Other <br />Building type: � Single Family J Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New x Addition Remodel Repair T I Sign Sprinkler Demolition Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : � <br />/y� ��� � ���cr � �n� z � ;�-�r%,-�,�1, �� ��� sfz ;-� �� � ;>u�-�, 1j i,����.�- ����-. <br />,, / �o(�1 / , <br />i l� �v� �l' � � C � "�` i c:: � �� �C�. � ��� /c=l C_�: � j c.-E='�'(i� / C_'--/ / � ��3V% • •'" � � ��� �:�� 6-'i,� �"�-� �� >� /� J� , �- _. <br />� �/ J �� <br />/i ,'i ����f C I �>��+``��'� r- � ����)l�,l � r�_�� ��C� /�r /c�-zr! 1 � . � � �C /c��� r' S�I�'r'��t �C:'�:'.l.-.�� y�L�����•t'(�� f. X' � <br />MECHANICAL PERMIT APPLICATION PLUMBING PIERMIT APPLICATION <br />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 ranqe <br />� Range hood <br />' Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />i Refrigeratior <br />Woodstove <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Type of Project: _New _Addn _Alteration _Repafr <br />Show Number (#) of fixtures <br />•�' � Toil�t <br />1 Bathtub <br />1 <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />DisPiwasher <br />Clothes washer <br />Water heater <br />Sink; (service/bar/mop/etc.; <br />Backflow preventer (inside <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Gre,�se trap <br />Roof drains <br />Meclical 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 comp <br />with whether s ecified 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 regulating construction <br />That I authorized the o, er of this property to perform the work for which application is made and I compiy with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />I <br />i — <br />_ � �^ ��� ��- <br />O ner/Aut ed Agent Signature Date � p (Revised 4/2015J <br />G' ��� <br />� <br />