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PERMIT APPLICATION <br />BUIL[)ING/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 />�-�::�%(-- �- <br />TAX # PERMIT # <br />�.�"L3S �c�.?.S�C� / J�('� � - <br />EGAL for new construction: Short PlaUsubdivision �� �� � Lot No. (attach copy of long legal description) <br />�' � i, � 1,� �`� �%�i����lCiCl.��jt �,-�-ll�'"iY� L f�."'1 <br />�WNER 1�'L�I.L� �� v T `'� � 'C�L•%��S Phone/E-maiN .� ,: -_ � -. . ,. -� _ s � c. <br />2Z. �31 t-� ��-L .�,- �c <br />APPLICANT: _�Owner _ Owner's Agent _ Contractor <br />CONTRACTOFt ��UCk.k ��"�N'�(�'S i�i'1nNI <br />Address {�j -1 � L � ��y� ��-� 1V t ! 1' 1�Y `3S <br />BUILDING PERMIT APPLICATION <br />City/State/Zip �CT�e '���j�i'� ��� CC �j �L�% <br />COf1Yf2Ci0� S Ag2flt _ TBIl2nt (must provide a letter of consent from the owner to do woAc in the space) <br />�-- � <br />State Lic. # 4-��`��\t��� 13 .}-vl ,� ]��City Bus. Lic. #�..� ��� <br />� �, ' �� � `i�''- Z�t'L`J <br />�.�. � � ���,�C` Phone/Emaii 'i;�?� ' 11C�CtCI.�����d}-�1p�3, (� <br />CONTACT FOR PERMIT ;�iC���f�������,��,���� <br />�.��--� � 4—� ��-� �� � � <br />Phone/E-mail �_� - Zt1ti - �°-1 Z r� <br />CONTRACT PRICE OF WORK � I `� �� <br />Existing' Use of Building HEAT SOURCE: <br />Proposed Use ��f Building `� �L=�= �►— 4� Gas l� Electric Other <br />Building type%'�� Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />( <br />Type of project: %L New Addition Remodel Repair T.I. Si n Sprinkler Demolition Chan e of Use <br />DESCRIPTION OF WORK (additronal space provided on the back) : <br />,,L �.�:�� � ;=LZ r � � �� ��. � � >� <br />?� �� L1�f��� �t- ��r3 �S �' �Z - c -��� � <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: 1LNew _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 range <br />Clothes drye <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Type of Project: X� New _Addn _Alteretion _Repair <br />Show Number (#) of fixiures <br />`� Toilet <br />� Bathtub <br />Shower <br />Kftchen sink & c <br />Dishwasher <br />Clothes washer <br />Sink (service/bar/ <br />Backflow prevent� <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certAy that have read and examined this application and know Ihe same to be We and correct. All provisions of laws and ordinances goveming this type of work will be comp <br />with w ether specif ed herein or not. The gr� ting of a permit does no[ presume [o give aulhonty ro violate or cancel Ihe provision of any other stale or local law regulatiny consiruction <br />That I nzed t ner t is pr ert r(ortn lhe work for which application is made and I compiy wilh Ihe State Contractors Law 1827 RCW and 296.200A WAC. <br />� �,�; '��� ����1 �s \ <br />Owne Aut rizc�d Agent Sig t re ___ - Date (Revised 9/2014) `'��'i <br />; �'__— . � <br />_.r _ <br />