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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: �� �� �� ^ �� � U�PERTY TAX # f Ef2MIT # <br />� � ���I�-�i�uo�o� -�����% -���7 <br />LEGAL for new construction: Short PlaUsubdivision <br />OWNER C i �✓' �I �-�%����� <br />Address Z'l �Jl�. �K�'�"1V1�(}1�'�-�:. 'T-rC <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail ��'V"Y� �ii�t';. �'�ZL+ G� M ��� <br />City/State/Zip �-1f�+�'�'�� �T � � � w � <br />T: _ Owner _ Owner's Agent _ Contractor _ Contractor's Agent � TeflBflf (must provide a letter of consentfrom the owner to do work in the space) <br />CONTRACTOR L�� �iC-� �,�,e' CLi�►�1ti,1I, CQ-�1 4f�iy L& I Lic. # c�c:r��.T� �v� k� COE Bus. Lic. # <br />Address pl.: V�%� (�7 �� �'�a � ���it, (,�„� j�r � �1''� �- �' Phone/Email 2 J 3 ' � rj � � � Z �'�'% <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />��.�i�lr�lo�� �� �1�Jfti.'�.�U.�i�YS Z!�(��_� �f�`{/i�.,'�42.1�( <br />Phone/E-mail � ; w�1,�:.�wS +� iY�tC't'u-� i�it.. �fw1 <br />BUILDING PERMIT APPLICATION CONTRACT RICE OF WORK Zi, atryC� -� <br />Existing Use of Building ('�JF--rL( C <br />Proposed Use of Building �l � <br />Building type: _ Single Family _ Duplex _Townhouse _ Mul�ti- amily 1/ <br />Type of project: New Addition Remodel Repair V T.I. _ Sig <br />DESCRIPTION OF WORK (additiona/ space provided on the back) : <br />/"�'�-C� �� S � i ►"�j � �'� (Cir �"�- 1� �?�..�i.�.l��'t���`Iv �'` C� <br />A , <br />.itZ�� �iG��i'� C ►� L���.� I �V �'�'R'� `� � �� �i (2' ( .S <br />MECHANICAL PERMIT APPLICATION � <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� A/C — air handling units <br />Forced air systems <br />�as rirepiace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />Other <br />�SUPPRESSI <br />Number of Heads <br />HEAT SOURCE: <br />� Commercial <br />n Sorinkler <br />of Use <br />�CC)t� ' ���i t�f'6'�t�'I✓1�-�� <br />i <br />� yl.� }zi.l,(,Cl-i� 1C/v <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />Bathtub <br />Kitchen sink & d <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/ba <br />Urin�� <br />Drinkirig Fountain <br />Floor dra � <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 true and correct. All provisions of laws and ordinances governing this type of work will be complied <br />with whe � specified herein or not. Th ranting 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 autho ' ed by the owner .� i property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br />i <br />� / �� ( � ��� �� � <br />waerlAut orize A e ignature Date (Revised 6/2012) `' � <br />_ �,, <br />