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PERMIT APPLICATIO <br />, BUILDIN�AECHANICAL. ! PLUMBING I SIGN . RINKLER ! DEMOLITION <br />CiTY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 982Qi <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/peemits <br />BUILOIidG PERMIT APPLICAT1011! -- <br />Existing Use of Building: Contract Price of Wo :$ � 0!� <br />Proposed Use of Building: Heat Source: ❑Gas �lectric ❑Other <br />Buiiding Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial <br />Type of Project: �New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolikion ❑Change of Use <br />DESCRIPTION OF WORK: <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL PERMIY APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: New _ Addn _Alteration Repair Type of Project: _New _Addn _Alteration _Repatr <br /># of Lisi of Fixtures # of Llsf of Fixtures # of ,�ist of Fiztures �°f List of Fixtures <br />Fixtures Fixtures Fixtures Fixtures <br />A/C — Air Handling Units Heat Pump Toilet Backflow Preventer (Inside Bldg) <br />Forced Air Systems Unit Heater Bathtub Urinal <br />Gas Piping Boiler Lavatory (Wash Basin) Drinking Fountain <br />Water Heater Refrigeralion 5hower Floor Drain <br />Gas Fireplace Wood 5tove Kitchen Sink & Disposai Grease Trap <br />Gas Range Ducting Dishwasher Roof Drains <br />Clolhes Dryer Hookups Other: Clothes Washer Medical Gas <br />Range Hood Water Heater Other: <br />Exhaust Fan Sink (Service/BarlMop/etc.) Other: <br />SPRINFCLER / SUPPRESSION SYSTEM <br />Number of Heads <br />ACKNOWLEDGEMENT: 1 have reviewed fhis application and confi�m the information contained herein is true and correct. Work done pursuant to this permii must comply with <br />current federal. siate, and Iocal law. The graniing of a permit only authorizes approved work and no deviations therefiom. Deviations must first 6e authorized in writing from ihe <br />Building Otlicra! before being authonzed under any circumslance. 1 am the owner. or ! am authorized by the owner of this property to perform the work (a which application is made, <br />and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />l� <br />OwnerlAuthorized Agent Signature Date <br />City o/ Evereft OHicial Use Only <br />PERMIT^#� �, � � � � _ ��� <br />C�%1� <br />(Revlsed 5/20/2016) a <br />\ <br />