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PERMIT APPLICATIqb <br />BUILDRO MECHANICAL / PLUMBING / SIG / SPRINKLER / DEMOLITION <br />EVERETT CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />WASHINGTON (P) 425-257-8810 i FAX 425-257-8857 i (E) everetteps@everettwa.gov I www.everettwa.gov/permits <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS:132 60TH PL SE EVERETT, WA,98203 PROPERTY TAX #: 00794100001800 <br />LEGAL for new construction: Short Plat/subdivision Lot No. <br />(attach CObV of Innn larval rloerrintir.�\ <br />BUILDING INFORMATION <br />Existing Use of Building: Residential <br />Contract Price of Work: $ b <br />©� <br />Proposed Use of Building: Residential Heat Source: E]Gas ❑Electric ❑Other <br />BUILDING USE: EISFR ❑Townhouse ]Duplex ❑ADU ❑Multi -Family - # Units: ❑Commercial ❑Accessory Structure <br />Type of Project: ❑New ❑✓ Addition ❑Remodel []Repair ❑T.I. ❑Sign ❑Sprinkler []Demolition ❑Change of Use <br />DESCRIPTION OF WORK: I -Adding a new door to side of building <br />2. Adding kitchenette to the entertainment room,, <br />3. Adding a new dryer and washer in the garage J <br />ASSOCIATED BUILDING PERMIT # (if applicable): % V <br />MECHANICAL <br />Fixture <br />Count <br />PERMIT <br />List of Fixtures <br />APPLICATION <br />Fixture <br />Count <br />List of Fixtures <br />Fixture <br />Count <br />PLUMBING PERMIT <br />List of Fixtures <br />APPLICATION <br />Fixture <br />Count <br />List of Fixtures <br />1 <br />A/C — Air Handling Units <br />Boiler <br />e e <br />Gas Piping <br />Gas Range <br />Heat Pump&Ductless <br />Backflow Preventer Inside Bldg) <br />a asher <br />Dishwasher <br />Shower, Tub, or Combo <br />Sink -Commercial (3-comp,prl <br />1 <br />Sink -Residential (kitchen,batt <br />Duct System Remodel <br />Y (Remodel) <br />Exhaust Fans (Residential) <br />Refrigeration <br />Commercial Ventilatio <br />(Not Heat/AC system) <br />Drinking Fountain <br />Floor Drain <br />Sink -Utility, laundry, mop <br />Exhaust Hood T e I <br />( YP ) <br />Toilet <br />Hose Bibb <br />Urinal <br />Exhaust Hood (Type In <br />Exhaust Hood (Residential) <br />Forced Air Systems <br />Water Heater <br />Wood Stove <br />Other: <br />Interceptor -Grease <br />Interceptor-Sand/Oil <br />Medical Gas <br />Waste/Water Piping Repair <br />Water Service (behind meter) <br />Water Valves or Fixtures <br />SPRINKLER/ <br />Su <br />Suppression <br />Gas Fireplace/lnserULog <br />SUPPRESSION <br />Svstem <br />SYSTEM <br />ni . u <br />RErainsWater <br />P <br />Se Ejector or sum EPum]pVater <br />Heater <br />Other: <br />ACKNOWLEDGEMENT: / have reviewed this application and confirm the information contained herein is tru <br />current federal, state, and local law. The granting of a permit only e and correct. Work done pursuant to this permit must comply with <br />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 l am authorized by the owner of this property to perform the work for which appli <br />and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. cation is made, <br />City of Everett Official Use Only <br />row ✓A"A_�/�1' �Iq(p� PERMIT # <br />�- oz,oe,zo2, 2� 0 2 <br />Owner/Authorized Agent Signature Date (Revised 10/101207u) <br />�/7i <br />