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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 wvuw.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />RESS: PROPERN TAX # PE MIT # <br />F i�2c� �. C,��.. �,-,� � a�r� 2—�i➢ <br />LEGAL for new construction: Short Plat/subdivision <br />VF37� eo�.,+rwr S /a-SS�c"�'h"v, <br />OWNER r/,. iun. D�_.� c,�,� ' c Or,,,-..,...1-.. Ma. <br />No. (attach copy of long legal description) <br />Phone/E-mail �19t5. �H7• 59vo <br />dress ��'J�3� /�JE $� 5{- S'k�"�.L 2pp ICity/State/zip �l�(��C ln�(�-, /(jUQCj <br />f <br />'PLICANT: _ Owner �Own2f�S AgBf1t _ COf1lf8ClOf _ CO�tfBCYOf�S A92�f _ TenBnl (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR �GLGvG{ l.t7n S'�Yu-�-'}1u�n LLC IL & I Lic. # <br />Address � � ��j /J �"I�� s'�_ .�<d}i-�l �/�lc� . <br />COE Bus. Lic. # <br />ne/Email 2(J�, 5�}5, %$37 <br />ERMIT �f �m �[ q�J ZCo�sw (i�}n�}-s. <br />PhonelE-mail ��`'�• 2�}�j• �7t32 <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK �, Z 3 �• y S <br />Existing Use of Building �(1�i1"/ e��7�'J�LY '�'S«ElVi/i'�Z HEAT SOURCE: <br />Proposed Use of Building %`/ea �G�f}'� �� Gas Electric Other_ <br />Building type: _ Single Family _ Duplex _Townhouse rr 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 provided on the back) : <br />� �/'.a � 2 f/v � �2. K. s4 � O %? �'G !'� .S UF T�" �-� <br />t� 3 ��r ir ft�J rs � r �- F�� r cy� �,E s���a`�.r-�,,yt, Gs�r�e�-� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtu�es <br />� A/C — air handling units <br />� Forced air systems <br />� Gas piping <br />� Water heater <br />I Gas fireolace <br />Clothes drye <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Ductir <br />Other <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixfures <br />Bathtub <br />Lavatory (wash basin <br />Shower <br />Kitchen sink & dispo� <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/moF <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 [rue and correct. All provisions of laws and ordinances goveming this type of work will be complied <br />with whether specified herein or noL 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 propeRy to perform the woric for which application is made and I comply with the State Contractors Law 1827 RCW and 296.200A WAC. <br />� 2 �2� 13 <br />Owner Authorize Agent Sig ature Date (Revised 6/2012) <br />tiz <br />