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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 />SITE ADDRESS: <br />LI <br />PROPERTY TAX # � PERMIT # <br />/�v� oo'-t3`1 iH ��o Z�i� s'�d50�'O <br />for new construction: 5hort PlaUsubdivision Lot No. (attach copy of long legal description) <br />lNER �l2-V� j CJV L'Z;C'v�^ <br />Iress � l;_ �!t!�, ��-� � <br />PLICANT: � Owner _ Owner's Agent <br />NTRACTOR , ��cC./:L��l�e;��?� „!�1v <br />ress n I �I � I_ I%iOrt�' �� � <br />LI�L <br />Contractor <br />BUILDING PERMIT APPLICATION <br />Phone/E-mail <br />City/State/Zip <br />�J � � �l `� �S 1L'1 C� � <br />�1 � � `1 ��Gi <br />Contractor'S A98flY _ T@I1811Y (must provide a letter of consent from the ovmer to do work in the spac <br />State Lic. # C� �7r,i�i..��LL ��'<<L City Bus. Lic. #„�%%,y "I � <br />�f.��� �f � Phone/Emai� Z � (�,, <br />CONTACT FOR PERMIT <br />� � r�� �7���� I ��( �i 4�, � <br />Phone/E-mail ` <br />CONTRACT PRICE OF WORK <br />Existing Use of Building <br />Proposed Use of Building � <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: � New Addition Remodel _ Repair _ T.I. _ Siqn Sprinkler � <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />��1� v�� �� �� 5� c 6L-c, �l `�-, L�t'C,,i= -�� t��.,� � �_d� r�,-��,�. <br />MECHANICAL PERMIT APPLICATION <br />of Projeet: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� A/C — air handling units <br />Forced air systems <br />Gas i in <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes dryer <br />� Range hood <br />Exhaustfan <br />Heat um <br />Unit heater <br />I Boiler <br />rtetrigeration <br />Woodstove <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />l. :`S <br />f V1.r%L,�UJ%�� � c. <br />,'�" <br />.. <br />� � �'�-. <br />HEAT SOURCE: <br />Electric Other <br />Demolition_Change of Use <br />5�� lo SF Cl +�;�-'� �.�= <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Lavatorv (wash basin) <br />Shower <br />Kitchen sink & disp <br />Dishwasher <br />Clothes washer <br />Water heater <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 />�.� . ���� <br />�Vt ���.C_�v`'1 <br />I hereby certiry thal I have r nd exa n d this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be compl <br />with whethe specified h in or ot. he anting of a permit does not presume to give authority to violate or cancel the provision of any other sfale or local law regulaling construction <br />That I a tt}O e y owne thi prop to rferm the work for which app'cation is made and I comply with the State Contractors Law 1827 RCW and 2962DOA WAC. <br />/ /��� <br />O�er/Authorized Agent Signature at (Revised 9/2014) � J � <br />l� <br />