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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 ADDRESS: ��} (], f� I PROPERTY TAX # PERMIT # <br />( l�(' �� \ � �/�l � (�' �', : , - �'�ti <br />LEGAL for new construction: Short PlaUsubdivision U- Lot No. (attach copy of long legal description) <br />OWNER �, � � �e�'�. �IC�lY7C�i��1� :'-1 <br />Address "-�j3J L' �L � I� ! y ��l 1-�-� <br />CONTRACTOR �G� � � yn � ', � -'� 'i�l�.'� 1 /) <br />Address i`feC �ty\�c,1 ' I � <br />'—(�c� � <br />TENANT BUSINESS NAME <br />BUILDING PERMIT APPLICATION <br />Phone/E-mail <br />L&ILic.# <br />;,� }-�,,,..ti�,�:ehone/Email '�� <br />ONTACT FOR PERMIT <br />1,`P �C-' 1-�t� . <br />ione/E-mail <br />ONTRACT PRICE OF WORK <br />Existing Use of Building � <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Z��— �`/3 �c�S�� <br />,,���� �fZS-3�13 �os�" <br />�� �--I C � . Cv-� <br />HEAT SOURCE: <br />Type of project: _ New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DeSCfiption of Work (additional space provided on the back) : <br />' �:.� ; �.�-��� �) cv�-�- � r LL ,�/�e I� � � 1� �1, �— �'�.c; V L S�. <br />�' � � ��. C�-�-'�,�„��-_ �-- r - <br />� ,�c_l�� r e - u�v� �� � <br />Have you started working without a permit? YES NO <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 fixfures <br />� A/C — air handling units � Toilet <br />Forced air systems Bathtub <br />Gas piping �_ <br />Water heater <br />Gas fireplace <br />� Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Boiler <br />Refrigeration <br />Woodstove <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />basin <br />Kitchen sink & di <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar <br />Urinal <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 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 perfor work for which ap t made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />�� <br />' �� Cp —ZU— � � <br />Ow Autho ' ed Agent Signature Date (Revised 2/2011J <br />�_.�' <br />