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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 /> SlTEADDRESS: �� �� � �„ ` U�� � PROPERTYT ��� T � � <br /> �(il.J <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER ����C�. �(�� Phone/E-mai �� � —�'�' Y�,����uu`v� �,c�-C� <br /> Address �(JC�� ��tJl St,�J U�,i�' City/State2ip <br /> APPLICANT:_Owner _Owner's qgent �ConUactor _Contractor's P�qent _Tenant�musc Proviae a iemero+consernrrom me ownerm do wo�c�n me space� <br /> i� i `, <br /> CONTRACTOR I'�I�l, S �I�Gf- ��'1.G. State Lic.# �, �j �{ � City Bus.Lic,#��j� <br /> Address�t�� � �` �'�` c�w (.� (lfl�� �`�'i` �C.u� Phone/Email �` �a'�jSl�j�j (Qy�r��y�„a j N .'�cYvL, <br /> ENANT BU INESS NAME CONTACT FOR PERMIT ,� <br /> PhonelE-maii (�t t(hSLLI Ll. �� """"`' '�� <br /> BUILDtNG PERMIT APPLICATION CONTR�4CT PR�CE OF woRK �'CpD�� - b <br /> Existing Use of Bui(ding HEAT SOURCE: <br /> Proposed Use of Building Gas ElecUic Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family !Gommercial <br /> T e of ro'ect: New Addition Remodel Re air T.I. Si n S rinkler Demolition Chan e of Use <br /> DESCRIPTION OF WO K(additional space provided on the back)� <br /> 'Q�,e��a.`r� �.S �irnr�c.�.- �c� Ctc�d�✓� <br /> � � ( � <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 fiictures <br /> � AIC—air handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas i in Lavato wash basin <br /> Water heater Shower <br /> Gas fire lace Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink senrice/bar/mo /etc. <br /> Heat um Backflow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby certiry that I have read and examined is applicaGon and know the same to be tnie and cort�ect.All provisions of laws and ordinances goveming this type of work will be compl <br /> with whether s cified in or ot.Th g ' g of a permit does not presume to give authority to violate or cancel the provision of any ofher state or local law regulating construction <br /> 7hat am aut ed t ow r of th p erty t pertorm the work for ich a plication is made and 1 comply with fhe State Contractors Law 18.27 RCW and 29B.200A WAC. <br /> F � � ( ( � <br /> er uthorized AgeM ignature Date (Revised 9/'2014) <br />