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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLIITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.org/� <br />ZS I O APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ? C��J ��Z <br />ADDRESS: , S � � ' /7 , PROPERTY TAX # PERMIT # ' ' <br />LEGAL for new construction: Short Plat/subdivision <br />OWNER e5 �C, � (/� <br />Address (� 7� / �l�'��50`( � <br />CONTRACTOR ,�-/'li/ / � f / rQ ��j I <br />Address ���(p ' �j�� /��- �, �QCQ� %?G� <br />�Y1 a� �s�`� �lov� <br />BUILDING PERMIT APPLICATION <br />a oH�� -ovZ-o - � <br />Lot No.� (attach copy of long legal description) <br />Phone/E-mail yZ J�— �� / — �Z� � <br />City/StatelZip fj(��Pi � �%�' 9gl�d3 <br />L& I Lic. #,�3 Z S% DD <br />d�z Phone/Email Z�3r I L�—�o OZ� <br />CONTACT FOR PERMIT ' <br />/5ra-e� SO�c z G- i a.�'�-.la-s-�- <br />Phone/E-mail Z -Z a — 7(p ;� <br />CONTRACT PRICE OF WORK /�, O%--`—"" <br />Existing Use of Building /�"/TT 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 />Have you started working without a permit? _YES X NO <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />wt; — air nandiing un <br />Forced air systems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refriqeration <br />[ Ducting <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />f %3�7 Number of Heads <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#J of fixtures <br />Toilet <br />Bathtub <br />Shower <br />Kitchen sink & dis <br />Clothes washer <br />Water heater <br />Sink (service/b� <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 certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances cloverning <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 work for which applicatio ' and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />_ ��--�p - �� <br />O A o ed- en igna ure Date (F'evised 2/2011) <br />� <br />� <br />