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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 /> APPLICA IONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: PROPERTY TAX# fj T#30 A <br /> �. <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address - t1 �(��/� City/State/Zip �' �� <br /> CONTRACTOR L&I Li c.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail/✓ c A, �� � � v <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building ? C HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric other_ <br /> Building type:X Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New —Addition _Remodel _Repair_T.I._Sign_Sprinkler—Demo Iition_Change of Use <br /> Description of Work(additional space provided on the back): <br /> Have you started working without a permit? 41YES _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 /> A/C–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 /> I Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> 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 perfortY6r filch application is de and I co/mply 'th the Staa Contractors Law 18.27 RCW and 298.200 WAC <br /> Owner/Authorized Agent Signature Date (Revised 2/2011) <br /> Z <br />