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' •P��nni�- A���.�c�►�ri�v <br /> �111LD'�VG/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOL,�TION <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: y�'�-J� PROPERTY TAX# PERMIT# <br /> �' 7 4�G'�C�C' �d— r ) �j'1 ; -�-��� <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of Ibng legal description) <br /> OWNER ,� �� J Phone/E-mail �� � , �� <br /> Address �;/� � �, , ,t�y.,,L ���� City/StatelZip �-=�a��i-te��E'1 t.�5' l� `i �L�Z - <br /> APPLICANT:�Owner _Owner's Agent _Contractor _Contractor�S A98flf _TBf18�1(must provida a letter of conseN from the owner lo dp work in the space) <br /> CONTRACTOR . f?� State Lic.# City Sus. Lic. # <br /> Address Phone/Email <br /> CONTACT,F , P R IT �.,� <br /> !<�ui,'1 �.SI���C�{15 � -3�..2�`I -�t1�'�( <br /> Phone/E-mail ---' vL; � �{ <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK_ ��, D�"' <br /> Existing Use of Building �- {� HEAT SOURCE: <br /> Proposed Use of Building �`�� 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(additional space provided on the back): � <br /> ii�'Ld(`t.J�l� j�-�sr�"�G',Ll�b>[�. +`1'�G'i:�.Yj ft�4_i,,�cf` y�,:i1�5 �IJD�..) l3dt.�i��` Cjlc�..':<>-- �Ylti��+;i)i (';f` j=/lC%L:�� <br /> � V � <br /> � ) 1 <br /> Jt"�)Uil_ic-v! l.� h%�1A1 �,ti� t l.�Aci`..�S�J(_�c '�'�.%L' 'n!�i'�fo�. �. 1����1u r-1' <^�tl rJ/�1�1G.� <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 J Kitchen sink&disposal <br /> Gas range j 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 /> ! Refrigeration Floor drain <br /> � Woodstove Grease trap <br /> 1 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 type of work will be complied <br /> wilh whether specified herein or not.The granting of a permii 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 the owner of thi propert perf LLe work for which application is made and I comply with the State Contractors Law 1827 RCW and 296200A WAC. <br /> ��� � - . � , ' �_�� /`,� <br /> ���� l <br /> -iju6`�ac�':����+.ii ;i..-:�i!` nf Si ature Date (Revised 4/2015) <br /> ��� <br />