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��RnniT �,�PL�c�Ti �v <br /> �UILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOL,ITIOIV <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# ERMIT#, `� ,� <br /> U � �.ii 1 i-�L�. ��:� ,c �1/—� A.� i , ^�; � .,.,r...�'�� <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of Ibng legal description) <br /> ') l <br /> OWNER '� ���- v ��% ��?� Lt✓c c � ` Phone/E-mail �U(- - 75�(s> —7 � � Z' <br /> Address � �UX �� � � City/State/ZiP �i(^�U��^y'�-lj;,. (�,}�- �"�j ,� Z 3 <br /> APPLICANT: Owner _Owner's Agent _Contractor _Contractor�5 A9ef7I _TE�BfIt(must provide a leqer of conseN from the ownef lo qp work in ihe space) <br /> CONTRACTOR State Lic. # City Bus. Lic.# <br /> Address Phone/Email <br /> CONTACT FQR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <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 providedon the back): <br /> .�c�j�'��i ����+-"�'✓e! �� �y'u V �, <br /> � �� � � .+ ,��.. . � ,� ;.�rc���L��>� ���✓ ti��� 5 f''u�- � <br /> e <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration TRepair 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 /> � 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 type of work will be complied <br /> wilh 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 296200A WAC. <br /> �-- � 2 2E1i� <br /> Owner uthorized Agent Signature Date (Revised 4/2015) <br />