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� ERMIT APPLICATIC�; <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 />/� � .1 �G n/.. � �T <br />ITE ADDRE�S: PROPERTY TAX #t PERMIT # <br />� ���� �c�.k�(��1� ���v�-��f �� � �i`� 2� � o� �-�v �� ���� � ��� <, ov -- . -� ,� <br />EGAL for new construction: Short Plat/subdivision Lot No. (attach copy of Ibng legal description) <br />WNER ,��b��'�.'•� 't� <<C�C,�., , I/1,-�. �V`,� �`,t Phone/E-mail v(L(' �2 E Z Z l� �01� ��rl� c� ✓1i15i� .�' <br />idress C� �� `�-�1,1(X1_ ��� �� l�`-c� lk�Ul (, City/State/Zip lS�j,�v1C �(''/L ��� ���1��-�' L1 <br />PPUCANT: _ Owner _ Owner's Agent _ Contractor _ Contractor�5 Ag2flf _ T2f13f1t (must provide a letter of consenl from the owner to do work In fhe space) <br />ONTRACTOR <br />BUILDING PERM•IT �►PPLICATION <br />State Lic. # <br />Phone/Email <br />T�a�7 McK�'y��- <br />hone/E-mail .?6v�2�1 -12/� <br />ONTRACT PRICE OF WORK <br />City Bus. Lic. # <br />� 7SQn�J�� �M <br />�r`; _ �'i <br />Existing Use of Building �>I %��� C E���L^tii �� �� ��'u C'� HEAT SOURCE: <br />Proposed Use of Building_ ��� Gas_ Electric_ Other <br />Building type: /� Single Farnily _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition � Remodel Repair T.I. _ Sign _Sprinkler _Demolition�hange of Use <br />DESCRIPTION OF WORIS (additional space provided on the back) : / / �C ��^ <br />' �C< �� rn�,�r� G�/,�a�f �u�� /�a � ��7o�r�-,. �'eskv� "`j <br />C�,� ��r� ex ,� f,%,<; s�� r� �v��n. �� / / /+ ,// } / / <br />1� , /� / / � '� ' !�( '�' nq on..^ rY�11pc-� t� a�) Tu//fAG� ./`�d� psJ l�an�G T� F-� T��ti <br />Li.Til^.�.sM- G� �� Tc.�1G�n • iZep IGCG lr�n ol✓.J. %Z[/��� � �� � l /� ✓ / � / /� I <br />4..-� �aJ .:.J�� �o �i���pl<c.< . OPG. ��r J'fu � J, %�le`r 2��- T�:�n�st.�'>> G� �l (iG�� A�LJG. RG� U GG ?�,� � s T�lJ <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />/� � Y Forced air systems <br />vvaier neater <br />Gas fireplace <br />Gas ranqe <br />eac pump <br />nit heater <br />i Refrigeration <br />' Woodstove <br />�' i Ducting -.3v' <br />I Otlier <br />RINKLER / SUPPRESSION SYSTEM <br />I Number of Heads <br />Type of Project: _New �Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />(2� x� Toilet <br />/zi x i Bathtub <br />�avatory �wasn aasin� <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />�inK �serviceipanmopietc.� <br />Backflow preventer (inside b <br />Urinal <br />Drinking Fauntain <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 true and correct. All provisions of laws and ordinances governing this type of work will be complied <br />wilh 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 />1'hat I am autho zed by the owner of this property to perform the work for which application is made and I comply with the Stale Contractors Law 18.27 RCW and 296.200A WAC. <br />�121( � <br />Owner/A t ori Agent Signature Date (Revised 4/2015) <br />� 1 Z_. .� <br />