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PERf1�IT° AF'PL.I��,TION <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 />SITE ADDRESS; � f <br />�r �/'L% �j r 1 (' 6- C�e'- � �l <br />LEGAL for new construction: Short PlaVsubdivision <br />OWNER J C��,�v�.L. `� C�, : JJ �.�� C.C1C,,�- <br />Address i(�-� L; �7 �- t(� � �,,�� � t� <br />APPLICANT: � Owner _ Owner's Agent _ Contractor <br />CONTRACTOR (`^, 1.�� <br />s <br />ROPERTY TAX # <br />Lot No._ <br />hone/E-mail �F <br />P <br />(attach copy of long legal description) <br />0 <br />ICity/State/ZiP E�� C' �. � T1 C J���L, � <br />G'c <br />COflffeCfOf�S A92fli _ TBf18f1� (must provide a letter of consenl from the owner lo do work in the space) <br />State Lic. # <br />Phone/Email <br />FOR PERMIT <br />Citv Bus. Lic. # <br />Phone/E-mail <br />BUILDING PERIVIIi APPLICAiIOIV CONTRACT PRICE OF WORK <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use o�uilding Gas_ Electric Other_ <br />Building type Single Family _ Duplex _Townhouse _ h�lulti-Family _ Cemmercial <br />Type of project: _ New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler �Demolit�Change of Use <br />DESCRIPTION OF WORK (addifional space provided on rhe back) : <br />� �1'�i(.� t� C' J �\� � <br />MECHANICAL PERMIT APPLICATION <br />pe of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />� Forced air systems <br />I Gas oipina <br />� vvater neater <br />Gas fireplace <br />� Gas range <br />� Clothes dryer <br />; Range hood <br />� Exhaust fan <br />� Heat pump <br />� Unit heater <br />� Boiler <br />� Refrigeration <br />j Woodstove <br />Ducting <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 />I Sink (service/bar/mop/etc.) <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 true and corred. 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 lo give aulhority to violale or cancel the provision of any other stale or local law regulating construction <br />That I am authorized by ihe owne� of this property to perform the work (or which application is made and I comply with the Slate Contractors Law 18.27 RCW and 296.200A WAC. <br />�Ll��:J � /�-��t,(_� !� <-� <br />