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� . � �. ' � �—�..11 <br /> �� c� � <br /> PERMIT APPLICATI4N <br /> BUILDING/MECHANICAUPL.UMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVEREIT PERMiT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 425-257-8810 FAX 425-257-$857 www.everettwa.org <br /> SITE ADdRESS: PROPER TAX# PERMIT# <br /> � � <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description} <br /> / OWNER � PhonelEmail . � <br /> ' ddres n City/State/Zip � <br /> APPUCANT:T OWmer _Ovuner's Agent ntractor _Contractors Agent �Tenant�musc Provde a�ener aconsem rrom�,e owner co ao woric in u�e spece� <br /> CONTRACTOR State Lic.# Ci Bus.lic. � <br /> Address Phone/Email C.( � <br /> T N �N s '�e! �(.0-�� cZAb 7Qi�l S3D Co nn+� a.r �.: <br /> �` cl " � r+� <br /> 1 c.� 1 1 1'�L� ` Phone/E-maii � �L. <br /> BUILDlNG P IT A�ATION CONTRAGT PRlCE QF WORK �'1 b <br /> Existing U�e of Buiiding HEAT SQURCE: <br /> Proposed Use of Building Gas Etectric Other <br /> Building type: �,Singie Famify ,T Duplex�Townhouse �Muiti-Famiiy ,_,_„Commercial <br /> T e of ro'ect: New Addition Remodel Re air T.L Si n S rinkier Demolltion Chan e of Use <br /> DESCRIPTION OF WORK(addit'na!s ace provided on the back): j`� �� <br /> GtSSoC�,��P p' ��v`r�� .� P�^'!'�'' ._� . <br /> j � � � . � . <br /> MECHANICAL PERMiT APPLICATION PLUMBlNG PLRMIT APPLICATION <br /> Type of Project: _New Addn ,Alteration,_Repair of ProJect: ,New Addn Aiteration_Repair <br /> Show Number # of ffxtures Show Number # of ffxiures <br /> A/C—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 osa <br /> Gas ran e ' hwasher <br /> Glothes d er Cto s washer <br /> Ran e hood Water ater <br /> Exhaust fan Sink serv ar/mo /etc. <br /> Heat um Backfl re ter <br /> Unit heater Urin <br /> Boiler kin Fountain <br /> Refri eration loor drain <br /> �. Grease tr <br /> Ducfin Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUP RESSI�N STEM Other: <br /> Number of Heads Other: <br /> I hereby c:ertify that I have read and examined this appNcation and knaa the same to be Uue and correct.A6 prov�ions of laws and ordinances goveming ttris type of work witl be comp� <br /> with wheUier herein or not.The gr8ndng of a permit does not presume to give authotity to vidate or cancel the provlsion otany other state or bcal law regulet�g conatnacUon <br /> t I am au ed by fh owner of this to perfortn the work for which apptiCBtbn is made and I Compy with the State Contractors Law 18.27 RCW and 298.200A WAC. <br /> . � ..�� <br /> oriz gent Signature Date (Revised 9/20i4).;•� <br /> �Z � <br /> . �'",_____.,''� <br />