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. �RlleliilT' AI'PL.ICATIC�� � <br /> �UILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOL,ITION <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: PROPERTY TAX# P RMIT# <br /> ��31 � �4 ��°. �U `Y � 1 J�-1 L�1 �L-G�' g� d�� � . ��wz, <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of Ibng legal description) <br /> OWNER C��� �1 �' � ����-� - � Phone/E-mail ,;2.�. (,*;�•�5 r,;�( <br /> Address '��,�,}a, �i � �L�� ,�� City/State/Zip �����"� `,JA C-3�:��' <br /> APPLICANT: Owner _Owner's Agent �'Contractor _Contractor�5 A98flf _TeflBflt(must provide a letter of conseN from the owner fo qp work in the space) <br /> CONTRACTUR � ���;� ��,{,� ��y�,� �r� � State Lic.# �� ���`��,� City Bus. Lic.# L���' <br /> Address �"1 ✓� '� �`"%�C_ ��� � �u� 'N"ii� �S'S c�.-��% Phone/Email � :�� -�� _.(J��-� <br /> CONTACT FOR PERMIT <br /> ,�--� 1 .>,�,.�._aey:- ��!b�h,L_:�u:�c�,/`- <br /> � i• � <br /> t=>���l..L� l C �� �Sc� Phone/E-mail �S �j�S j -L� �,�I . `'�' C 5�L�.t LLN-C '� �Aha`��D l <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building ��"�4'�„�(C�/1 HEAT SOURCE: <br /> Proposed Use of Building ��2.�.-,�1.� �as Y-� Eiectric other_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family�Commercial <br /> Type of project: New Addition P Remodel Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): � ��„ <br /> .�r_s �-«U� ��;� �D i���c� -- <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration C�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 bidg) <br /> Unit heater Urinal <br /> � Boiler Drinking Fountain <br /> I Refrigeration Floor drain <br /> � Woodstove � Grease trap <br /> I Ducting � Roof drains <br /> � Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM ' Other: <br /> Number of Heads Other: I! <br /> I hereby certify that I have read and examined this application and know the same io be true and correct.All provisions of laws and ordinances governing this type of work will be complied <br /> wiih 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 authorized by th wner of this property to perform the work for which application is made and I comply with the State Contractors Law 98.27 RCW and 296200A WAC. <br /> , � c <br /> � <br /> �, - �-1� <br /> wnerlAuthorized Agent Signature Date (Revised 4/2015) <br /> �� ���' <br />