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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ITE ADDRESS: PROPERTY TAX q P M # , q�', � <br />�y�-o 39�'` St��.c� � Ev��, I,J►� oos��oo3�.00c�� ����u'��� ����'��=; <br />LEGAL for new construction: Short PlaUsu <br />Iress gq 1 9 �,p� <br />PLICANT: Owner <br />ONTRACTOR <br />T-r�. ob� 1 �. <br />v i,e�,� Ade E v.e.� <br />No. (attach copy of long legal description) <br />Phone/E-mail <br />City/State/Zip <br />Owner's Agent _ Contractor _ Contractor's Agent �C T011211t (must provide a letter of consent from the owner to do work in the space) <br />. <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building 1�.�'t_�.2.$S �-0..�<<� �-v� <br />L&ILic.# <br />� Phone/Email <br />�ONTACT FOR PERMIT <br />�4�.�� 4tr- 8s3�6 � <br />'hone/E-mail r,��,�-�, , � <br />COE Bus. Lic. # <br />��� <br />t- Wtnb i <br />CONTRACT PRICE OF WORK ,^: �..� 0'�7'p <br />r <br />HEAT SOURCE: <br />Proposed Use of Building � Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family X- 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) :!-Mo j�; ��,, i g loroQOSi �-o $ s�0..� <br />q e.x:s� �� o�.+.,��e-w�--o..o. �� a r...� cti.wt2-v�..�,a o�..S� �,J�.DI c� ad-e� <br />o,�,�.�c,� \:..�y �-t.w�.�~,-� C w�..v�s , cov� � �y1��� d ��� � <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A!C - air handling units <br />Forced air s stems <br />Gas oipina <br />Gas fireplace <br />Gas range <br />Clothes drye <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />' SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Toilet <br />Bathtub <br />Shower <br />Kitchen sink & disp� <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <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 be complied <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 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 />��� <br />_ � NI �. � 3 ,�. <br />[ <br />Owner Authorized Agent Sign re Date (Revised 6/2012) <br />