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• • <br />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 ADDRE,,SS: � �, PROPERTY TAX # P RMIT # <br />� -�� �� �c� �e►� l,u c�� �� � � � � � �� , u � S ► �� �5 -- ��1 <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER 5 I Phone/E-mail <br />Address � �f " � � City/State/Zip �f �- � �(j �i <br />APPLICANT: _ Owner _ Owner's Agent _ Contractor � COf1tf8Ct0��5 AgBflt _ T8f18f1t (must provide a letter of consent from the owner to do wurk in lhe space) <br />CONTRACTOR `' � y `-� 1' State Lic. #M1� F�, j_,�C.�t, City Bus. Lic. #'�y � � <br />/,nf�/�-/Z 'S(Z(1 '-I Z �f - 1 � ; 5 <br />Address ��y"' ��`!� �'t[�}',.f �'I � I W �� iS �1�� �)�r �!`u1. �.iZ � �'S /=- l ) P�ione/Email �i-P �-1011 f�i'�(Y10i Cs'�� i li.'�n . / r���Vi <br />v�. � �� v�. r � � � <br />��ie� 1�v��-`� �te�u��� t�+�d��u;s� ��e ��-�3-�� <br />� �(i�� v� Phone/E-mail S ' " <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WC <br />Existing Use of Building C�l'� t'Li 3� :�h�� <br />Proposed Use of Building �J�CY�� <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family,� Commercial <br />Type of project: New Addition Remodel Repair _ T.I. � Sign _Sprinkler <br />DESCRIPTION OF WORK (additiona/ space provided on the back) : <br />����t-�l���r� � �I1urv��n�+��i ltiu�t� Siy�LS <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />A/C — air handlin units <br />Forced air s stems <br />Gas pipin <br />Water heater <br />Gas fire lace <br />Gas ran e <br />Clothes d er <br />Ran e hood <br />Exhaust fan <br />Heat um <br />Unit heater <br />Boiler <br />Woodstove <br />Ductin <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />�c� <br />HEAT SOURCE: <br />of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fixtures <br />Toilet <br />Bathtub <br />Lavato (wash basin) <br />Shower <br />Kitchen sink & dis osal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.; <br />Backflow preventer (inside <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 6e comp <br />with whether specified herein or not. The granting 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 authonzed by the owner of this property to perfortn lhe work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br />� � <br />S" <br />Authorized nt ignature Date (Revised 4/2015) <br />�C� <br />