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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 />�ADDRESS: PROPERTYTAX# p��T� � � `� 1 <br />/U 1„/ lM�..�:�.�1.�� 1�,,� �—��:.r-..t1. i /n �,o,�' <br />1L for new constru <br />ER _� I�� <br />PPLICANT:� Owner <br />Short Plat/subdivision Lot No. (attach copy of long legal description) <br />�(—�,% Phone/E-mail L�a� ^ ���C/ '��.�j(�,�j <br />City/State/Zip ��-- ���F�, <br />Agent _ Contractor _ Contractor�S A jBflt _ Teflaflf (must provide a letter of consent from the owner �o do work in �he space) <br />BUILDING PERMIT APPLICATION <br />L&ILic.# <br />Phone/Email <br />FOR PERMIT <br />Phone/E-mail <br />CONTRACT PRICE OF WORK <br />COE Bus. Lic. # <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas Electric Other <br />Building type: _ Single Family � Duplex _Townhouse _ Multi-Family _ Commercial <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) : <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 piping <br />Water heater <br />� Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Bathtub <br />Lavatory (wash k <br />Shower <br />Kitchen sink & di <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <br />Urinal <br />Drinkinq Fountain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby cerlify that I have read and examined lhis application and know the same to be lrue and correct. All provisions of laws and ordinances goveming this type of work will be complied <br />wfth whelher specified herein or not. The granting of a permit does not presume to give authority to violate or cancel ihe provision of any other state or local law regulating construction <br />That I am authorized by lhe owner of lhis property to perform the work for which application is made and I comply wdh the Slate Contractors Law 18.27 RCW and 296.200A WAC. <br />E C _ _ � <br />O er/Au ized Agen ignature Date (Revised 6/2012) <br />