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PERMIT <br />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 ,VVAv.everettwa.0rg � <br />1/1 -1 `IS <br />SITE ADD $ESS: ^ r <br />PROPERTY TAX <br />PEgh,�IT#O( —0� <br />ii <br />n <br />LEGAL for new construction: Short Plaf/subdivision_ _ Lol No._ (ailach copy of long legal description) <br />OWNER AU i 6+-S J <br />Phone/E-mail <br />Address/(, <br />CitylStatelZip <br />/� <br />APPLICANT: —Owner _Owner'sAgenl Contractor Contractor'sAgent _Tenant(mustpror:aoafetterofconsentfromdido ertadowoA'nthe seore)• <br />LContractor's <br />CONTRACTOR I� A2E'� e`,o)f{=4-9 G LG <br />State Lic. #i-^f FZ+SL 87/ CA City Bus. Lic. # 35 DoO <br />' ` <br />Address //O3 �S%rG/s�! 12 (� r ^zt� L�(l/� Phone/Email <br />CONTACT FOR PERMIT ,p>/ �-Oec <br />px-� <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK'• DU <br />Existing Use of Building — . __—_ _ HEAT SOURCE: <br />Proposed Use of Building Gas _ ElecMc_ Other_ <br />Building type: _ Single Family G Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of project: New — Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler __Demolihon__Change of Use <br />_ <br />DESCRIPTION OFWORK (adddionalspace pmvidedonthe back): � 0� �A5 �i,��� -` <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project:—New_Addn _Nleration _Repair <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Show Number (#) of fixtures <br />NC — air handling units <br />Toilet <br />Forcers air systems <br />_ <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water healer <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer _ <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (service/barlmop/etc.) <br />Heat pump - <br />_ <br />Backflow prevenler (inside Bldg) <br />Urinal _ <br />Drinking Fountain <br />Unit healer <br />Boiler <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease Ira <br />Ducting <br />Root drains <br />_ <br />Other_ _ — <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Olher. <br />Number of Heads <br />Other. <br />I hereby comity 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 "I be compl,ed <br />wish whether cdied herein or not. The granting of a permit does not presume to give authority to violate or omcei the provision of any other slate or local law regulating conslructbn <br />Thal I a u)odmu by Ihn owny/oljo!�Ppropody to pedogAhe work for which application is made and I comply with the Slate Contractors Law 1927 RCW and 296 200A WAC. <br />(Revised 412015) <br />