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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />•nnpprcn corxY R AU Tn A PM /-1 �,'I <br />SITE ADDRESS: PROPERTY TAXa P IT — <br />34 ciq Na Est WA 95z0i, <br />LEGAL for new construction: Short PlaVsubdivision Lot No._ (attach copy of long legal description) <br />Phone/E-mail BA@0A,4'A!;j5CO•M� <br />OWNER F3.%\ <br />Address 307 <cvc VAu`<iJA-ev <br />citylstalelzip WA 7 <br />CONTRACTOR U w h eC L& I Lic. 0 <br />PhonelEmall <br />Address <br />TENANT BUSINESS NAME ICONTACT <br />FOR PERMIT i <br />911\1.1 1�0• "'..\� <br />` ` <br />Phone/E-mail g• ovs�:v�� .Gaff` <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK - <br />HEAT SOURCE: <br />Existing Use of Building <br />Proposed Use of Building Gas W Electrlo V Other <br />Building type: Single Family _ Duplex _Townhouse _ Mufti -Family Commercial <br />_ <br />Type of project: _ New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _,Demolftlon ✓ Change of Use <br />Description of Work (additional space provided on the back) : <br />C.+., G [:tit J .SC <br />Have you started working without a permit? _YES —NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Adtln _Alteration _Repair <br />Type of Projact: _Haw _Addn _Alteration _Repair <br />Show Number (a) of Natures <br />Show Number of Nafures <br />Toilet <br />NC - air handling units <br />Forced airs stems <br />Bathtub <br />Levator • wash basin <br />Gas piping <br />Water heater <br />Shower <br />Kitchen sink & dis osal <br />Gas fire lace <br />Gas range <br />Dishwasher <br />Clothes d at <br />Clothes washer <br />Water heater <br />Ran a hood <br />Sink servicelbarimo letc. <br />Exhaust fan <br />Heat um <br />Backflow Dreventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refri eration <br />Floor drain <br />Woodslove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be We 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 slate or local law regulating construction or the performance of construction. That I am authorized W the owner of this property <br />to perform the rk for which application is made and I comply with the State Contractors Law 1e.27 RCW and 29e.200 WAC <br />Owner/Authorized Agen Signature Date (ReWsed 7/2011) <br />Ala <br />