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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 />ADDRESS: <br />"�3z6 �'�,'i .� � �lVe i=ve.-L. .'I� <br />TAX ti <br /># <br />for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />r <br />2 �%A� ��� �c� PhonelE-mail 1 =,. � ; 5 _ � Ci )� <br />-��2� 'l-�i- � �V� c��yis�a►eiz�p �v�_�e� �/� ��� l <br />ANT: _ Owner � OWnErS Agenl _ COntfectOf _ COnifeCtO�'S AgCnt _ Tenellt (must provide a lener ot consent from the ovmer to do work in me <br />� � <br />CONTRACTOR D IvJ � d f' Y State Lic. # City Bus. Lic. # <br />ress <br />,— <br />�.'UCc� ��1Cd�5� �✓ � <br />BUILDING PERMIT APPLICATION <br />Phone/Email <br />OR PERMIT �� �^ �5 V _�2 �� <br />n � </ <br />� 1i � ��� �C✓,�7 � � �v�j i� � ¢ <br />i1 <br />PRICE OF WORK �'� C�:�; <br />Existing Use of Building �� /_�`7 _ HEAT SOURCE: <br />7 <br />Proposed Use of Building Gas� Eiectric fi <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family �Commercial <br />Tvoe of oroiect: New Addition Remodel Reoair T.I. Sion �Snrinkler Demolition Char <br />DESCRIPTION OF WORK (add�tiona� space provided on the back) : <br />�1.� Ivt�4 /V't'_ l,`-' _�/�Ci 1/ �G� <br />I (.� <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 />Gas pipin4 <br />Gas fi <br />Gas r <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />Ductin <br />� Other �{--�:�, r � �� d✓ <br />SPRINKLER / SUP RESSION SYSTEM <br />_ �- <br />— � Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />' Bathtuh <br />Dishwasher <br />Water heater <br />Sink (senrice� <br />Backflow pre� <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />�ther: <br />Other: <br />I hereby certify that I have read and examined this app6cation and know the same to 6e true and correcL All provisions of laws and ordinances goveming this type of work will be comp <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 1 am authonzed by Ihe owner of this property to perform the work for which application is made and I compfy with the State Contractors Law 18.27 RCW and 296200A WAC. <br />� <br />�� — f' : -- � �� ��� <br />