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PERMIT APPLICATION <br />BUILDING�CHANICAL / 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 />OJECT SITE ADDRESS: � � �� u-Q � � 1, ,� � �� PROPERTY TAX #: <br />! ! <br />�LEGAL for new construction: Short Piat/subdivision Lot No. (attach copy of long legal description) � <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: Contract Price of Work: $ '"' �J <br />Proposed Use of Building: Heat Source: ❑Gas lectric ❑Other <br />Building Type: ❑SFR-Detached �FR-Attached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial <br />Type of Project: ❑New ❑Additiofi ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: <br />� �%'t C -�1,� S s �--�-L �. �- f �� w�` �, � �. �-� ._zL L t <br />ASSOCIATED BUILDING PERMIT # (if applicable): <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: New Addn Alteration Repair <br />Fixtures List of Fixtures Fixtures List of Fixtures <br />A/C—Air Handling Units Heat Pump <br />Forced Air Systems Unit Heater <br />Gas Piping Boiler <br />Water Heater Refrigeration <br />Gas Fireplace Wood Stove <br />Gas Range Ducting <br />Clothes Dryer Hookups Other: <br />Range Hood <br />Exhaust Fan <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: New Addn Alteration Repair <br /># of List of Fixiures #°f List of Fi�rtures <br />Fixtures Fixtures <br />Toilet Backflow Preventer (Inside Bldg) <br />Bathtub Urinal <br />Lavatory (Wash Basin) Drinking Fountain <br />Shower Floor Drain <br />Kitchen Sink & Disposal Grease Trap <br />Dishwasher Roof Drains <br />Clothes Washer Medical Gas <br />Water Heater Other: <br />Sink (Service/Bar/Mop/etc.) Other: <br />ACKNOWLEDGEMENT: I have reviewed this application and confirm the information contained herein is true and correci. Work done pursuant to this permit must comply with <br />current federal, state, 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 />Building Official before being authorized under any circumstance. 1 am the owner, or 1 am authorized by the owner of ihis property to perform the work for which application is made, <br />and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />Agent Sig�ure <br />City of Everett Official Use Only <br />� � I � 1 � � � PERMIT/�� � � �I � <br />I I I <br />Date (Revised 10/12/2015) <br />