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PERMIT APPLICATIOWINKLER <br />BUILDING / MECHANICAL / PLUMBING / SIGN / DEMOLITION <br />EVERETT 32CITY OF EVERETT PERMIT SERVICES <br />00 CEDAR STREET, EVERETT, WA 98201 <br />WASHINGTON (P) 425-257-8810 1 FAX 425-257-8857 1 (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />3ROJECT SITE ADDRESS: 34 D �, ,VOr tuA �ye PROPERTY TAX #: 0 f' `� zi j �� � � 0 A f oo <br />_EGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />BUILDING INFORMATION - <br />Existing Use of Building: �� , (� f ck M Q .5 —� o 4e Contract Price of Work: $ <br />Proposed Use of B ilding: /� ; n I e M 7 P\Q .) i 461d Heat Source: MGas ❑Electric ❑Other <br />BUILDING USE: SFR ❑Townhouse ❑Duplex ❑ADU ❑Multi -Family -# Units: ❑Commercial ❑Accessory Structure <br />Type of Project: ❑New tAddition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: �p hI (Abe <br />oll)bw r(\c reg5eA 6 LA� �vofi 9e 0-f 52 s t /Ve V✓ sP9ce <br />v <br />6 0( �2 i �^ l o gFts, /1'� t mU }� n C! f f �� 9 (it'd �n � 1 n Q� _t q f fPfS �o t' l,fo F't <br />ASSOCIATED BUILDING PERMIT # (if applicable): 0' � I�fi / P ? � � � c ' � �� + <br />r1 st61� (o) �i v>n a f v/ <br />MECHANICAL <br />PERMIT <br />APPLICATION <br />PLUMBING PERMIT <br />APPLICATION , Vv�+/, <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />List of Fixtures <br />A/C —Air Handling Units <br />Gas Piping <br />Backflow Preventer (Inside Bldg) <br />l <br />Shower, Tub, or Combo <br />Boiler <br />Gas Range <br />Clothes Washer <br />Sink -Commercial (3-comp,prep,floor) <br />Clothes Dryer <br />Heat Pump&Ductless <br />Dishwasher <br />Sink -Residential (kitchen, bath, bar) <br />Duct System (Remodel) <br />IRefrigeration <br />I Drinking Fountain <br />Sink -Utility, laundry, mop <br />( <br />Exhaust Fans (Residential) <br />Commercial Ventilatior <br />(Not Heat/AC system) <br />Floor Drain <br />Toilet <br />Exhaust Hood (Type 1) <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type II) <br />Water Heater <br />Interceptor -Grease <br />Waste/Water Piping Repair <br />Exhaust Hood (Residential) <br />Wood Stove <br />Interceptor-Sand/Oil <br />Water Service (behind meter) <br />Forced Air Systems <br />Other: <br />Medical Gas <br />Water Valves or Fixtures <br />Gas Fireplace/]nsert/Log <br />Roof Drains <br />I ( <br />lWater Heater <br />SPRINKLER / SUPPRESSION <br />SYSTEM <br />Sewage Ejector or Sump Pump <br />Other: <br />Water Suppression System <br />No. of Heads <br />(Chemical Suppression System I INo. of Heads I I I I <br />ACKNOWLEDGEMENT: 1 have reviewed this application and confirm the information contained herein is true and correct. Work done pursuant to this permit must comply with <br />current federal, state, and local law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing from the <br />Building Official before being authorized under any circumstance. I am the owner, or I am authorized by the owner of this property to perform the work for which application is made, <br />and / comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />PERMIT # � <br />J1 ;/1CC �t�J'�tJ'lU <br />Owner/Authorized Agent Signature Date (Revised 411512019) <br />