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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 />ADDRESS: PROPERTY TAX # �R T # <br />� E. GA�INo P.�� Ev ��2�T. cJ� a S2o 3 24��b'1 ar� 301 I c7� �� ���_,°�) -(� C/� <br />LEGAL for new construction: Short PlaUsubdivisio <br />OWNER <br />dress <br />No. (attach copy of long legal description) <br />Phone/E-mail 4�Si • h?9) • <br />Owner � Owner's Agent _ Contractor _ Contractor's Agent _ Tenant �m�sc Pro��de a ietter or cooser,i trom ine owr,er to do work �r, tne sPace> <br />ONTRACTOR I <br />idress � J�f)(Q <br />L& I Lic. # F/"► �jQ('j COE Bus. Lic. # <br />(�� �8� � Phone/Email 'r( 2�' �j2q <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />YaPrf��!,,�Ol�o�� ► D1/�IA+-� � n.tG. <br />Phone/E-mail si'GS-Z-�j�� �'��p( (�(LEj-'O �ih'�fAj•� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK `} Z�� Li:.i�.`'�= <br />Existing Use of Building �(,�SIZ(7�l�i HEAT SOURCE: <br />Proposed Use of Buiiding ����� 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 on the back) : <br />kDbtfh��l OF 2��7�- �� U.�d"L�f"'� !/��'iN W�.C�:`iG P-AcrtQS ,��t�' eiGlw�crL v'�jr�l�r[���2 <br />C� iJ.l� t� ta S,-(}� {�*-SLT'PcC�ifc w� l,� tJ L� i'� L�,�t; � f�►� v,,�rCEY�. M iA�t�l - <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 piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />� Water heater <br />Sink (service/bar/mop/etc.) <br />vrease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />in <br />I hereby certify that I have read and examined this application and know the same to be hue and correct All provisions of laws and ordinances governing this type of work will be complied <br />with whether specified herein or nol 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 I am authorized by the owner of this 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 />-2'0 Z <br />l3 <br />wner/Authorized Agent Signature Date (Revised 6/2012J <br />