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, <br />• <br />� <br />PERMIT �PPLICATION <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 />ITE ADDRESS:�. //('/ PROPERTY TAX # PEy�R�M�aT� #U� _ <br />f/.✓�lE� b/ � rCr\�C I� ! "� ' J 1 ✓ <br />EGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />WNER ��«,/ii ,%y� `�� ` ' �� Phone/E-mail <br />� �. , � <br />�dress j 5 �, �- i,-.. ; � City/State/Zip <br />PLICANT: _ Owner _ Owner'S A90fll _ COf7lf8CtOf _ COf1ff8CfOf�S AgBflt _ TBIl2(12 (must provide a letter of consen� from the owner to do work in the space) <br />� � ,��, /�_, � � j-�<� /�•� �-�%,� <br />_ �� <br />� . ��/ � ��_ , � 1 <br />� <br />NESS NAME <br />/ �, ,�.',�� <br />Lic. # ;�%' �s� ^-': � City Sus. Lic. # <br />Phone/Email <br />�ACT FOR PERMIT <br />�E-mail �� � �" � � �'� �� <br />BUILDING PERI1011T APPLICATION ICONTRACT PRICE OF WORK <br />Existing Use of Building �'=��� �"� <br />Proposed Use of Building - ;i�"' i =`•� "'- �`� �� �� <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family . <br />Type of project: _ New Addition � Remodel � Re air � T.I. �� <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�� ��••-.� , L , �` ss� <br />�� <br />HEAT SOURCE: <br />,��s� �- �-C�c�'"� Other <br />Commercial <br />Sprinkler Demolition Chanqe of Use <br />j � A - � �li.i _-_ ..- ,; -.: ; . �.��'-. <br />lc�'� � , �'.., ,..� , . , . ..a, .? .�`�.. �. j. . . t <br />�'' '✓e �.: .�-, ` = i 4� '«-,�:,, � . / � <br />_,f'�` �`, .�s \,.' :�� _� ..,: � �"�r( ;';L-'�- <br />i> <br />�7� �TfS, ;i � �-{-... <br />MECHANICAL PERMIT APPLICATION PLUMBING 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 pipin��� <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes dryer <br />� Ran e hood <br />Exhaustfan <br />Heat um <br />Unit heater <br />� Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin <br />Situwei <br />Kitchen sink & dispos <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/moK <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 certify that I have read and examined this application and know the same to be irue and correct. All provisions of laws and ordinances governing this Iype of work will be compl <br />with whether specifed herein or noL The granting of a permit does not presume to give aulhonty lo violate or cancel the provision of any other state or local law regulating consWction j <br />Thal I am aulhorized by the owner of this property to per(orm the work for which application is made and I comply with the Slate Contractors Law 18.27 RCW and 296.2DOA WAC. � 1� <br />. " / <br />[ <br />fr'�...'�''� .�F�':.9'.�. i �... _. <br />Owner/Authorized Agent Signature Date (Revised 9/2014) <br />