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• <br />• <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 />E ADDRESS: .,, PROPERTY TAX #� n_ �„ . P RMIT # <br />%� C �� � �,�k� l ,i � /�-t; C ��{' �:� �� �� � �2�� 5� �� � i �,� - G � <br />iAL for new construction: Short Plat/subdivision________________________Lot No._ __ (attach copy of long legal description) <br />OWNER �L� < < (�-1�1� Phone/E-mail <br />4ddress �L;) � (�' L��(,� ; '� City/State/Zip <br />APPLICANT: ___ Owner ___ Owner's Agent ___ Contractor ___ Contractor�S A9eflt __ T01l8f1t (must provide a letter of consent from the owner to do work in the space) <br />CONTRACTOR (��(J �- � L& I Lic. # COE Bus. Lic. # <br />Address Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT � �2'� 7 <br />Phone/E-mail ���� "c�r� • �� z " 2-��� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK " �Z�'C' <br />Existing Use of Building _____"��'r ��� <br />Proposed Use of Building_____ <br />Building type: Single Family _ Duplex __Townhouse __ Multi-Family _ <br />Type of project: New __ Addition Remodel Repair ___ T.I. __ Si <br />DESCRIPTION OF WORK (additional space provided on the back): <br />�L.. i�� �� �--� F� l L I 1� �-�j �T�-' <br />MECHANICAL PERMIT APPLICATION <br />Type 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 />Unit heater <br />Boiler <br />Kerrigeration <br />Woodstove <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />Electric Other <br />Commercial <br />Sorinkler <br />`/ � l� �-`�--� <br />of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: ___New ___Addn .___Alteration __Repair <br />Show Number (#) of fixtures <br />Toi let <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.) <br />Backflow preventer <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />Other: <br />I hereby certrfy that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be complied <br />with whether specifed herein or not. The granting of a permit does not presume to give aulhority to violale or cancel the provision of any other state or local law regulating construction <br />That I am authorized by the owner of this prope�tyjoperform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />t <br />Owner//luthorized Agent Signature <br />� <br />, -7 � � Z.- <br />�� � <br />(Revised 6/2012) <br />