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PERMIT APPLICATION <br />�UILDING/MECHANICAL/PLUMBING/SIGIV/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 />� <br />1L for new construction: Short PlaUsubdivisio <br />ER �/�LC � d /�/ eV /� <br />PPLICANT: � Owner _ Owner's Agent _ Contractor <br />ONTRACTOR <br />RTY TAX # <br /># <br />� <br />No. (attach copy of long legal description) <br />Phone/E-mail � ) �� ���^ � �S � <br />ICity/StatelZip ���"' LG� � `� ��� � <br />COf1ff8CfOf�S A9211f _ T2flaflf (must provide a letter of consent from the owner lo do work in the space) <br />State Lic. # <br />IPhone/Email <br />CONTACT FOR PERMIT <br />Bus. Lic. # <br />Phone/E-mail <br />BUILDIIVG FER�r�IT APPLICA`� I�Ol�i CONTRACT PRICE OF WORK GODD <br />Existing Use of Building G4�Q,4 G.cL�' HEAT SOURCE: <br />Proposed Use of Building C7�-2i=�G� 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 dditiona! spa e providec,' the back) : <br />{�%1��' _��� �.�(�'� �� i� �'--c� �� <br />_ T <br />i//Vl!✓,���/T/��'� �7/�-2�4G���,�oP <br />MECHANICAL PERMIT �.�PL�ICA'�lON PLUMBING PERMIT APPLICATION <br />Type of Project: _P+ew _Addn _Alteration _Repair <br />5how Number (#) of fixtures <br />�- A/C — air handling units <br />v� 1 Forced air systerr�s <br />i Gas piping <br />� � Water heater <br />; Gas range <br />Clothes dryer <br />Range hood <br />i Exhaust fan <br />j Fieat pump <br />� ur�;t heater <br />! B�i�er <br />; Refrigeration <br />Woodstove <br />Ducting <br />j Other <br />SPRINKLER / SUPPRESSION <br />Number of Heads <br />M <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fixtures <br />; Toilet <br />� Bathtub <br />i Lavatory (wash basin) <br />i Shower <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mo <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 lhe same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied <br />with wh �ther specified herein or not. The granting of a permit does not presume to give authorit� to violate or cancel the provision of any other state or local Iaw regulating construction <br />That I arn authorized by the owner of this property to peRorm the work for which application is made and I comply with thz State Contractors Law 18.27 RCW and 296 20CA WAC. <br />t �(� <br />�� � ��- � �` � � � <br />OwnerlAuthorized A nt S' n ure Date (Revised 3/2013) <br />