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I APPLICATIO� <br />ERM T <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 />;� <br />%��� �Q!% <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />,�� .. �- �� �% � ��-����-�6��> , �� �, <br />OWNER G, ,�". �" , //'" 1�7/liil�� Phone/E-mail <br />ress <br />CONTRACTOR <br />ress <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building r � �� � <br />City/State/Zip �!/���� <br />L&ILic.# <br />Phone/Email <br />CONTACT FOR PERMIT <br />Phone/E-mail � ��� G� <br />CONTRACT PRICE OF WORK <br />��� <br />HEAT SOURCE: <br />Proposed Use of Building� � _ I Gas_ Electric_ Other <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />� <br />Type of project: _ New _ Addition �Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DesCription of Work (additional space provided on the back) : , r <br />. 1 <br />��i���'G� ��c� ,���.�`�� GJ: ��- �� <br />��P V�' I G - ���c,� <br />Have you started working without a permit? �YES NO <br />MECHANICAL PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Forced air systems <br />Gas pipin4 <br />Gas ra <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />SPRINKLER / SUPPRESSION <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Lavatory (wash b� <br />Shower <br />Kitchen sink & dis <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/ <br />Backflow preventE <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />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 pertorm tYie or�r which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />� "t"- �''�� � � `� � <br />�OwnerlAuthorized Agent Signat e Date (Revised 12/2010J ' <br />p <br />�'�'1. <br />