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• 0 <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 /> SITE ADD ESS: PROPERTY TAX# PERMIT#. <br /> _69 Sof Z Owl CC), G <br /> LEGAL for new construction: Short Plat/subdivision _Lot No. (attach copy of long//legal description) <br /> OWNER Phone/E-mail l� 3rt�' <br /> Address ti, :2& 2 City/State/Zip Fi,! <br /> CONTRACTOR j j A L&I Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT if t v� ((p� O <br /> Phone/E-mail v j 336 Y 3 ' <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric Other <br /> Building type: _Single Family —Duplex_Townhouse —Multi-Family _Commercial <br /> Type of project: New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Description of Work(additional space provided on the back) <br /> 16 Id 0�. Co- ()X-i <br /> Have you started working without a permit? _YES XNO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C–air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace i chen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water hater <br /> Exhaust fan Sink(se 'Fe/bar/mop/etc.) <br /> Heat pump Backflow,pr enter <br /> Unit heater ( Urinal <br /> Boiler Drinking Founta% <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> I Ducting Roof drains <br /> Other `. Medical Gas <br /> SPRINKLER/ SUPPRESSION SYS M I Other: <br /> Number of Heads I Other: <br /> 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 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 perform the w*for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> , I , L ` � '-)3, <br /> Owner/Author/ ed Agent Signature Date (Revised 2/2011) <br /> l <br /> jZ <br />