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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 ADDRESS: <br />%?L' lr!-" �-' c�-� tv �[.� � t i� ; <br />LEGAL for new construction: Short PlaUsubdivision <br />OWNER "� t�\ �ti i�r-`�y ��,���.�; t�-�-C_..- <br />iress .�.'Sc`S��Z�- USe �(c.^-t�� ._�, ���i'r����w:� <br />PLICANT: _ Owner _ Owner's Agent _ Contractor <br />ONTRACTOR �'� i _. ���=_ <br />dress <br />:NANT <br />BUILDING PERMIT APPLICATION <br />PROPERTY TAX kl P` MI <br />�f=r=�-'c'�;:�_. ['�.-!'���.T l R��i -'-C'(�C. ' � � I V�'iC <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail ;t�:�,: _ � . `.._� .- �. ; � <br />-� - . <br />� <br />h�, �, City/State/Zip �•4, �> ��v,� L'� �) �,� ;.t.-� � 1,' _`�-- `� <br />_ Contractor�5 A98fll _ T8fl8flt (must provide a letter of consenl from the owner to tlo work in the space) <br />State Lic. # <br />Phone/Email <br />Bus. Lic. # <br />4}\��"_ � >r..c �_ . —��`:� - `����:..�- �_;<,l�t_ <br />Phone/E-mail li�t���.:�-`-'�i�� � �- vv\�-l-�l•'�-L ti✓� <br />� <br />CONTRACT PRICE OF WORK <br />Existing Use of Building '�C l�-\� � l� J� � <br />Proposed Use of Building <br />1� <br />Building type: _ Single Family _ Duplex _Townhouse �C 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 />HEAT SOURCE: <br />Gas Electric � <br />Demolition Chanae of Use <br />. '`w <br />�-�- _ � � � � j� � � -� n� �xP�r�c� Q�r��� -�- <br />�� <br />�-� ,�,� � v�Yv� �t � L� 1jV 1�'�-�l� f/�t C c��. <br />MECHANICAL PERMIT APPLICATION <br />pe 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 />Water heater <br />Gas fireplace <br />i Gas range <br />� Clothes dryer <br />( Range hood <br />—� Exhaust fan <br />Heat pump <br />( Unit heater <br />Boiler <br />'I Refrigeration <br />� Woodstove <br />I Ducting <br />; Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />x���l-�s <br />PLUMBING PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />Bathtub <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/e <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby ceriify 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 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 regulating construction <br />That I am authorized b,y the owner of this propeRy to pertorm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />j r: <br />i , r) , <br />�- ��, /7 �� �l <br />Owner/Autho zed A2�} t Signature D te (Revised 3/2013) <br />