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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 />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />ITE ADDRESS: � n�,� �� 1t � _ r��/� PROPERTY TAX # PE`�R,9MiT�#' �–r� C\ � <br />(r(d ,r� (/l% � <br />for new construction: Short PlaUsubdivision __ _________________Lot No.____ (attach copy of long legal description) <br />NTRACTOR <br />��[�n,�.�' � C <br />BUILDING PERMIT � <br />sting Use of Building <br />���%��v <br />� r � ' . -' . <br />CONTACT F�R PERMIT ��+ i�p� <br />Phone/E-mail ��jY�7��lS � <br />TION CONTRACT PRICE OF WORK GIF�-- <br />Proposed Use of Building________________________ �_ <br />Building type: ___ Single Family __ Duplex ___Townhouse ___ Multi-Family � Commercial <br />Type of project: __ New ___ Addition ___ Remodel __ Repair __ T.I. � Sign ___Sprinkler <br />DeSCription Of Work (additional space provided o,nit�ie back) : <br />� U l �"��' (�/�-�._r'r,��� � <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 />i Forced air svstems <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 />W oodstove <br />Other <br />SPRI LER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />Other <br />Demolition___Change of Use <br />PLUMBING PERMIT APPLICATION <br />of Project: ___New ___Addn ___Alteration ___Repair <br />Show Number (#) of fixtuies <br />_ � � Toilet <br />Bathtub <br />Shower <br />Kitchen sink & dis <br />Clothes washer <br />Water heater <br />Sink (service/ba <br />Backflow nrever <br />Drinkina Fountain <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 governinc <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 ovi ion 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 r r�e^ork for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />l' <br />tl � <br />Agent Signature - " Dafe — (Revised 2/2011J <br />