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� <br />• <br />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 />9Q.DRESS: PROPERTY TAX # P�g MIT # <br />� 1 s2� ,� � /' �,;.. . ,n _ _ �l V-� 0 2n2 _—✓� <br />LEGAL for new construction: Short PlaVsubdivision Lot No. (attach copy of long legal description) <br />VF3TL Goc..+rw�'S /a-SS��"a'�ur� <br />OWNER L/" �r PI.-orSon �S nrnrur�l^t, �`i4uaainna, Phone/E-mail �%%S. %�1�•5�W / j��n,��,��r <br />�ress I`J`b31 /VE $�' Si- r,S'�.�.�-�-� 2vu ICity/State/Zip '���� .�� . G%Pj(�p� <br />PLICANT: _ Owner �Owner'S Agent _ ContfaCtof _ ContfaCtor'S Agent _ Tenant (must provide a letter of consent from the owner to do vrork in ihe space) <br />� <br />I (15 nl I'f0� Sfi <br />BUILDING PERMIT APPLICATION <br />�C �L8�ILic.# <br />�l� . <br />COE Bus. Lic. # <br />Phone/Email 20L, 5�5, %Qj37 <br />R PERMIT „Jrw11L ac�J ZCo�Sk �i�}�v�s. <br />ne/E-mail �25.2'i$. 17ti2 <br />NTRACT PRICE OF WORK ��'2., �'IIP�- .�1 7 <br />Existing Use of Building �UGi/ e�.�7*'l�LY �5ls:a�"!Vi/i'� HEAT SOURCE: <br />Proposed Use of Building �/a �t�/9'� Ev� Gas Electric Other_ <br />Building type: _ Single Family _ Duplex _Townhouse J� Multi-Family _ Commercial <br />Type of project: New Addition Remodel }CRepair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back) : <br />!'�.��'',� f 2 NL ��L d�c. o'`} f O %%��G l'� $' raF "'"�t7` <.3," <br />('� � PJ �+r f 9' /1�'! �� i �- F�`ri"', i 4�' �•Z.E S'<�aL�l"P,y�, �s��'Gt''� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />SPRINKLER <br />A/C — air handling units <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Woodstove <br />Ducting <br />Other <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 />� Lavatory (wash basin) <br />I Shower <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/ba <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 rype 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 296200A WAC. <br />�� � 2 �2� ( 3 <br />Owner Authorize Agent Sig ature Date (Revised 6/2012) <br />.,/� <br />