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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: P � C • n t, � PROPERTY TAX # PER T ,^ <br />�'� ( ; r L� ��; � _�C n, i 1,�� l .�'�-{� � % .� � � �i � � c� � -ol� <br />EGAL for new construction: Short PlaUsubd <br />�wNER ��;1 r�l-;�t,r `{��Li-�t � i t � <br />C�.z.�J j t.�:L�1i�. <br />PPLICANT: � Owner _ Owner's Agent <br />NTRACTOR �~' � ��=� t,_�` <br />� � � ��. �,� ( `-<. � <br />ress� <br />JANT BUSINESS NAME <br />Lot No. (attach copy of long legal description) <br />`.r 1Phone/E-m <br />City/State/Zip <br />-��-������ 1y1� . tl��- <br />�( l��:3��.. (' � l� t= _^ <br />� <br />�>, r��trY��a�_l1 � t�'��v� <br />i �- j CG., <br />Contractor _ Contractor�5 A9Bflt _ T0fl8flt (must provide a letter of consenl from the owner to do work in the space) <br />�-c (_�,�{` ,{; � % L & I Lic. # :., �'v �-� l..0 ( r��� ��`� � COE Bus. Lic. # v�3�(;� ) � <br />BUILDING PERMIT APPLICATION <br />i7 �� LC�( Y �� 7)y Phone/Email �"��� .�r� � . 1 <br />CONTACT FOR PERMIT, <br />r• <br />M G.,'=� �; �L.i��.�� vt.. ,`i-25 - 2_3�- ��-`� 1 I <br />Phone/E-mail ' ' j ' ') � . C ' ; � -� <br />CONTRACT PRICE OF WORK 20: DC� O _ <br />ExistingUseofBuilding ��I t,�►^l,(�c,f1i�-i �=(��1C�i{�i'��L�'s�� <br />Proposed UseofBuilding�t�LS���'L� 1 �^���� ��'�frL� �� ; Gas <br />Building type: _ Sing!e Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: New Addition _ Remodel Repair _ T.I. _ Sign _Sprinkler _Derr <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />�v�Yl �'1���- t�c9�-h i�l.��.���.��--t_� 5' ���%r-��Gr� Gk.,.� -�y�� v��� <br />��-i �= i ��-��'� c� v�-� f�� c- r� r�����. �-, �i � c- � c�t-�_, c�,c�ol" y-,-�c�l �_ � <br />r�� �� � t c� �.i� �,=� c>F' f�:D�C �-f�� ��.i��tc`� e-�. � ��� �'. <br />HEAT SOURCE: <br />� Electric� Other_ <br />olition Chanqe of Use <br />L,�>iti� IIrYLtcGf j� E^C'6 <br />E�r.-�� �-u���,-���-, <br />MECHANICAL PERMIT APPLICATION PLUMBING 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 />Gas piping <br />► +Water heater <br />I Gas fireplace <br />Clothes drye <br />Ranae hood <br />Heat pump <br />Unit heater <br />Boiler <br />� i rtetrigeration <br />� Woodstove <br />� Ducting <br />I Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fixtures <br />j Toilet <br />Bathtub <br />� Lavatory (wash basin) <br />j Shower <br />Kitchen sink & disposal <br />Dishwasher <br />i � Clothes washer <br />Sink (service/bar/m <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 true and correct. All provisions of laws and ordinances governing this type of work will be complied <br />with whether specified herein or not. The granling 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 296 200A WAC. �. <br />_ 7 � , . 1 <br />� <br />`���L�����(l"c � �/ �/ 'Z <br />Owner/Authorized Agent Signature Date (Revised 6/2012) <br />