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� 'ERIViI°T APPLICe4T1C,� . . <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEtiIIOLITION <br /> CITY OF EVERETT P�RMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITE ADDRESS: PROPERTY TAX# PE IT# , <br /> :�i ��t ' �v ��� 1 U - C�L <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of Ibng legal description) <br /> OWNER � -� C � �i "���� Phone/E-mail �„�j � j�y `fy�(4; � <br /> Atldress � 3 � ���L� � A�Je, City/State/Zip �4rVr�'��/,+(� � �, ( <br /> APPUCANT:_Owner _Owner's Agent CO�lfaCtOf _COf1YfaCtOf�S A9Bfll _T@�8flf(must provide a letter of consenl from the owner to dp work in Ihe space) <br /> �y' <br /> CONTRACTOR � � )�� •�,; � i��i) ,.1a; State Lic.# ���+- 1 w.� f�(�G.�C 4� City Bus. Lic.# � 7L <br /> Address �L; �� �'�j�i� �� ���1��j_� ��� Phone/Email ,�ei(�, ���. — f� 3� <br /> CONTACT FOR PERMIT <br /> c.��H/� f� Ll��'a.=��Cs rt:' <br /> ,.Jt�;..��.v 5i:,���' 'ct i 1,.�,z..►a.e�h��t�r.c�( :: c.:..-'►-� <br /> �v�,r 1����i�t� �v�� � Phone/E-mail , �, � �- ti3 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK P� ", �� ^L <br /> Existing Use of Building C .a.i�., HEAT SOURCE; <br /> Proposed Use of Building �it�� �'�V:����� 'C� Z. �as 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(additronal space provided on the back): <br /> /�������.� � '�� 5}'.v+ � C���J 'f"i.1 v in4.C_�'S <br /> , <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn �Alteration_Repair Type of Project: ^New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater � Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink (service/bar/mop/etc.) <br /> Heat pump Backflow preventer(inside bldg) <br /> Unit heater Urinal <br /> � Boiler Drinking Fountain <br /> I Refrigeration Floor drain <br /> i Woodstove � Grease trap <br /> I Ducting � Roof drains � <br /> ! Other � Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads 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 lype of work will be complied <br /> with whether specified herein or noL The granting of a permit does noi presume to give authorily to violate or cancel the provision of any other state or local law regulating consiruclion <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 /> /��• �c�^ <br /> wner uthorized Agent Signature Date (Revised 4/20i5) <br />