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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 1 3200 Cedar St., Everett,WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX#I/00 sl'+‘1 5t 0o4nsta001.16-1- P n1I104 00 <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER prpvj i..-4." Phone/E-mail <br /> Address 1X61 I.Pa01, v` SW 066/LD City/State/Zip t 'y' 1„01 14YOs1 <br /> CONTRACTOR Sw. . 'Err— Sybilve'S L&I Lic.# <br /> Address 11014 VI"- 4v_ 6 TovAwv_ w4 L 14911 Phone/Email$-7LI*'I'ifb a y{,\; <br /> TENANT BUSINESS NAME Nkcitar I CONTACT FOR PERMIT 150.,SS <br /> I✓ •e-At <br /> I <br /> 1 J - PhonelE-mail l- S r-Z.& s IOOISS •Lim-- <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ]� 7L,.� <br /> Existing Use of Building Nbt.V.VA. HEAT SOURCE: <br /> Proposed Use of Building 1}sSQI+4 Gas_ Electric Other <br /> Building type: _Single Family`_Duplex_Townhouse _Multi-Family • Commercial <br /> Type of project: _New _Addition _Remodel _Repair K T.I._Sign it Sprinkler Demolition Change of Use <br /> Description of Work(additional space provided on the back): S l 1 <br /> — Old") w�,► •-^'��-�'s p ,t .5 to OA") &1 NNAG. ,0 Tr tajt -o <br /> Have o" u started working without a permit? YES NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New_Addn _Alteration_Repair Type of Project: New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> NC—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/SUPPRESSION SYSTEM Other: <br /> l/ ( Number of Heads Other: <br /> I hereby certify that I have read and examined this application and know the same to be true and correct.All provisions of laws and ordinances governing <br /> this type of work will be complied with whether specified herein or not.The granting of a permit does not presume to give authority to violate or cancel <br /> the provision of any other state or local law regulating construction or the performance of construction.That I am authorized by the owner of this property <br /> to perform the rk for WI' a lication is made and I comply with e State Contractors Law 18.27 RCW and 296.200 WAC <br /> Owner/Authorized Agent Signature /e (Revised 2/2011) <br />