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PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425 :57-8810 FAX 425-257-8857 wv✓w.everettwa.org <br />SITE ADDRESS: <br />( LG r <br />PROPERTY TAX # <br />PERMIT # <br />LEGAL for new construction Short Plat/subdivision Lot No._ (attach copy of long legal description) <br />OWNER TLG/,` S Grr-t' <br />PhonelE-mail <br />Address <Ao <br />City/Slate/Zip <br />APPLICANT:_ Owner Owners Agent _Contractor _ Contractor's Agent _Tenant (must poocea lehirorccosenl lmm'th...er0 it. All lho epacc) <br />CONTRACTOR/%il <br />Slate Lic. # G City Bus. Lic. #etc <br />Address SL�G7 �giwg Phone/Email <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />PhonelE-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas_ Electric. _ Other_ _ <br />Building type: _ Single Family _ Duplex _Townhouse Multi -Family _ Commercial <br />Type ofproject: New Addition Remodel Repair T.I. Sign Sprinkler Demolition Chan a of Use <br />DESCRIPTION OF WORK (additional space provided on fie back): <br />13aeA, lva4el' lr�'ylVC %/1 t3nSencn1 <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Type of Project: _L�New_Addn _Alteration _Repair <br />Show Number(#) of fixtures <br />A/C — air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory wash basin <br />_ <br />Water healer <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink service/bar/mo IetcJ <br />Heat pump <br />Backflow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refricteration <br />Floor drain <br />_ <br />Woodstove <br />Grease Ira <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />I <br />Other: 8S,4A, WG It/ Va rk <br />Number of Heads <br />Other: <br />I hereby that I have mad and amined this application and know the same to be mue and correct. All provisions of laws and ordinances governing this type of work will be compl <br />con to owpe herein oL Tha granting of a permit does not presume to give authority Io violate or cancel the prevision of any other state or lout law regulating conslm0tion <br />am aulhonxed by p0 work forwhich application Is made aid I comply with the Stale Contractors Law 18.27 RCW and 296 200A WAC. <br />Owner/Authorized Agent Sigdature Date (Revised 92014) <br />