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PERMIT APPLICATIO <br />BUILDIN MECHANICAL 1 PLUMBING / SIGN�RINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />� 3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps@everettwa.gov � www.everettwa.gov/permits <br />PROJECT SITE INFORMATION <br />ROJECT SITE ADDRESS:� � � � �� ��� PROPERTY TAX #: d �� ��' ,t �� �y � ¢,l� <br />"7 1 <br />EGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />� Use of Buildinc <br />ed Use of Buildi <br />BUILDING PERMIT APPLICATION <br />—�' Contract Price of Work: <br />= Heat Source: as <br />Building Type: SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units:_ <br />Type of Project: ❑New ❑Addition ❑Remodel Repair ❑T.I. ❑Sign ❑Sprinkier <br />DESCRIPTION OF WORK: <br />' F -t k�- �t'7"�- �'� <br />IATED BUILDING PERMIT # <br />❑Electric ❑Other_ <br />❑Commercial <br />❑Demolition �Chanc <br />�. c� r-�- c�.�"�� C�t� <br />�� i ���--11-�-rJ <br />ACKNO <br />currenti <br />and 1 <br />❑Industrial <br />of Use <br />PWMBING PERMIT APPLICATION <br />Type of Project: _New _Addn Alteration Repair <br /># of List of Fixtures # of List of Fixtures <br />Fixtures Fixtures <br />Toilet Backflow Preventer (Inside Bldg) <br />� Bathtub - Urina� <br />Lavatory (Wash Basin) Drinking Fountain <br />Shower Floor Drain <br />Kitchen Sink & Disposal Grease Trap <br />j Dishwasher Roof Drains <br />Clothes Washer Medical Gas <br />Water Heater Other: <br />Sink (Service/Bar/Mop/etc.) Other: <br />VT. I have reviewed fhis application and confirm the information contained here�n �s true ana correct. wonc aone pursuanr ro rnis penni� mus� c����N�y w���� <br />and local law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing from the <br />�being authorized under any circumstance. I am the owner, or 1 am authorized by the owner of this property to perform the work for which application is made, <br />S�te Contractors Law 18.27 RCW and 296.200A WAC. <br />=�' '-��'��� <br />Signature <br />Crty of Everett Officral Use Only <br />PERMIT # 1 <br />,�—y ,1 � '�, � <br />1 +�'� <br />Date � ��.���-�Revised 10/12/2015) � <br />�� <br />