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• • <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 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# PERMIT# <br /> l � �%SY 7,,e'5GG""�i'��a �N1 Cj vUZ <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER V Phone/E-mail /may <br /> Address !: Z,–, U /(�� City/State/Zip <br /> CONTRACTOR e--V L&I Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Davieta e- <br /> Phone/E-mail LVt' d <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORKer J <br /> Existing Use of Building '� cv laL� ��1�!/�y HEAT SOURCE: <br /> Proposed Use of Building -1 Gas_ <br /> Elect, other_ <br /> Building type: <2 Single Family _Du lex_Townhouse —Multi-Family _Commercial <br /> Type of project: —New —Addition Remodel _Repair_T.1._Sign_Sprinkler_Demolition_Change of Use <br /> Description of Work(additional space provided on the back) <br /> lovllv <br /> Have you started working without a permit? YES _NO >//� ✓�n�� ✓C��� <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 /> A/C–air handling units I Toilet <br /> Forced air systems ( Bathtub <br /> Gas piping Lavatory(wash basin) <br /> j 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 /> Number of Heads i Other: <br /> 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 ofany-G r state or local law regulating construction or the performance of construction.That I am authorized by the owner of this property <br /> to pe or the prk.I tch-app kation>made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> Owner/Authorized Agent Signature Date (Revised 2/2011) <br />