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i'ERIlIIIT AF'PLICATI��I <br /> BUILDIN(�/MECHAIVIC,AL/PLUMBING/SIGN/SPRItVKLER/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 /> S E ADD ESS: `""--�} PROPERTY TAX# � ' PE MIT# <br /> �� ��� � � `� '�' � '� Y � , 7 � � � �_ �' �, �. ' � �� � <br /> LEGAL for new construction: Short PlaVsubdivision Lot No. (attach copy of Ibng legal description) <br /> OWNER > �_ � C� Phone/E-m .�-`.�,C(�3. �_ �. ' �-L �t �'I'� <br /> Address� ;" ' �`� � � — c�tyistateiz��� �� � C' " �' <br /> APPLICANT: ' Owner _Owner's Agent _Contractor _Contractor'S Ag2f7t _TBflBfll(must provida a leqer of consent from Ihe owner to dp work in R�e space) <br /> CONTRACTOR J State Lic.# j�N City Bus. Lic. # <br /> Address � Phone/Email <br /> G AC •FQR PERMIT , -. . <br /> ��"�%� Y1`� C�(.r�'�� �!GIGlGC��y1 c?I • L'�-C���� <br /> � � Phone/E-mail '��, 2 � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE F WORK <br /> Existing Use of Building � � HEAT SOURCE: <br /> Proposed Use of Building ����'y�'�'(�.i f Gas 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(additiona!space provided on the back): • • <br /> c����u�� ��.����� �������ti������ �e�� y��s�����. .�-��.���� , �u ��� �� ���<� , <br /> �c�'�SC�'t�'J-E. �-C``f�1k iT C�-��[,��'�f,v10E'viL'.�S • <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 5how 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 <br /> , Exhaust fan � Sink(service/bar/mop/etc.) <br /> - Heat pump Backflow preventer(inside bidg) <br /> — Unit heater Urinal <br /> Boiler Drinking Fountain <br /> 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: <br /> I hereby ceRify that I have read and examined this application and know ihe same to 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 io give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That I am authorized by th ner of this property to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296200A WAC. <br /> � ; �� � ' �C � � � <br /> OwnerlAuthorized Agent Sig at r �v�,, �T4 a�J D e (Revised 4/20i5) <br /> �� !tvl� 1 <br /> � r'�\�Z �l <br />