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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: /�_ ,' PROPERTY TAX # P RMIT # f11 <br />Zj�G �'��'9l'��r�=� "TVti- �iL%y"��I� 7�%��7�1J�' �SI�IJ��VI� <br />LEGAL for new construction: Short PlaUsubdivision <br />No. (attach copy of long legal description) <br />'NER � { �j E- �?.�Cti Z�- � � - �'-r" Iti Phone/E-mail '� �'S� ZS �- % Z� `i. <br />ress 'L�1 �C°, �,�-{^��'(,l�r� :'i�vZ- City/State/Zip Z V"�'���f"' I�ti �{ �'� �Z�% � <br />'LICANT: _ Owner _ Owner's Agent _ Contractor _ Contractor's Agent �2f18f1t (must provide a letter of consent from the owner to do work in the space) <br />NTRACTOR L.� �.�w ��re���.��M��✓, C.' 1C%�0> L& I Lic. # L-�C�I�C..TZ �'l`JS kC-7 COE Bus. Lic. # <br />ress � i.� �)�, i� � 4?�.% 4.�v i � �''� l,(,) � `� �� �L- Phone/Email � � 3 ' ���- e z1 `t <br />�T ����Eti� ���� <br />BUILDING PERMIT APPLICATION <br />CONTACT FOR PERMIT + � / <br />�F'�� ,�:� � � . E: i� tin- � U,l� �iG�V tl4'vr`�-S <br />,���� ���.9� � y. n� /� <br />Phone/E-mail 'ZL'� - 3 `fL�-'-� Z"j �'f � �'� iG' /"uC:i `-�C. C�+�� <br />CONTRACT PRICE OF WORK 1'�rGV� <br />Existing Use of Building ii �'1�-!= ���' � WZ-6t S� t;rti ;�i`C'r HEAT SOURCE: <br />Proposed Use of Building � t: �y"��1�.- 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 o,a. the back) : <br />��ir�aG%� �� ��`j �L �.� � 1�1 ✓�� U�l� l/'��-�� +�i�C�� -- �..,���.c;°�v`�. ��� fi r � Gti✓i-te��LS ���v1 <br />��? �t'�i'I�"tC �%S �� e c� f-�',�' , 7" 1'--I �J'� � 1/�YL ;.° r� % t1�(%�� �� lt ���+,,�ei � r� 1-�- V� �A � 1�;rt,� . f-G <br />"��t t�i U�— e� l��'-� �-j'"d �.� v� 5 t:._ .�'tZ� t a L C�`t,�r ✓� �� r-'L� i�i' ��tc-c v d1 . <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fiixtures <br />i A/C - air handling units <br />, Forced air systems <br />Water heater <br />Gas range <br />Clothes dryer <br />; Range hood <br />Exhaust fan <br />j Heat pump <br />-� Unit heater <br />i Boiler <br />i Refrigeration <br />Woodstove <br />Ducting <br />� Other <br />RINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Lavatory (wash basi <br />Shower <br />Kitchen sink & dispc <br />Dishwasher <br />Clothes washer <br />Water heater <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby ce ' 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 whe er speci herein or not. The grantin�o permit d s not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I a a�prized y the owner of this pr e to perfor e work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br />Z� /�. ��Z �Z� -%� <br />"nerlAuth rized e t Si ature Date (Revised 6/2012) <br />��a <br />