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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES r <br />� �� � <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.org �� , 2v �- <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />E ADDRESS: - PROPERTY TAX # PERMIT # ., r- <br />� �( Z I�I�,�,' �l Zv i- -- c; ti>> <br />iAL for new construction: Short Plat/subdivision Lot No. (attach copy of long Iegal description) <br />'NER ) C Y/ �/) /�t�l�J. ���'� � �. L. i._ Phone/E-mail 1�Z�� 6 I L�� _'j� � Z.,/Sc_-� ��in`� ��(s�-��.`�i or cn,�., <br />� �L <br />TRACTOR <br />B <br />BUILDING PERMIT APPLICATION <br />City/State/Zip ���� ��,; <br />L&ILic.# �C�C_�C.l_F� <br />Phone/Email <br />FOR PERMIT <br />hone/E-mail <br />)� c �.�� <br />,� � <br />PRICE O�F WORK �'���%,� <br />Existing Use of Building (Jt9 ( c� .t �— HEAT SOURCE: <br />Proposed Use of Building �/ e.d/I. �A- Gas Electric_ Other <br />Building typ�e.�'�.� Single Family _ Duplex _Townhouse _ Multi-Family _ Commer I` � <br />Type of project: _ New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Spri ler�_I' Demolition Change of Use <br />DeSCription of Work (additional space provided on the back) : � a� ���, "L �•..i ��-1l j ----� � <br />�.K- � � � <br />�-(�—u ���� cJ�.�, ti/ �� 5 C <br />Have you started working without a permit? _YES�'l NO i� �� � <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />of Project: _New _Addn _Alteretion _Repair <br />Show Number (#J of fixtures <br />� A/C-air handling units <br /># Forced air systems <br />� Gas piping <br />I Water heater <br />Gas range <br />Clothes drye <br />Range hood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Ductinq <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />of Project: _New _Addn _Alteretion _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />Lavatory (wash basi <br />Shower <br />Kitchen sink & dispc <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mc <br />Backflow preventer <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <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 atl7roY�her state or local law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to perf e work for Which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />� _ ��� � I�U1 S� �, � �� � L�� -�z� ! <br />Ownerl t rized Agen gnature Date ���� � l� (Revised 2/2011) <br />�/ _.. � <br />