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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 />\ I/� APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM L� I� i`(FC -( ;(` <br />ITE ADDRESS: <br />r_�— �57� SGl�t� <br />EGAL for new construction: Short PlaUsubdivision <br />WNER �►e�Lre, ovc� <br />Address � 7U � �-�Q/'�'(�5l�y] IJ�G-j <br />cotvT�ncroR �/'l�( r � �j`/'� S� <br />Address ����p �� �� � ` <br />TENANT BUSINESS NAME ' <br />�f�je��rc� �lwe <br />v <br />BUILDING PERMIT APPLICATION <br />0 <br />Lot No. (attach copy of long legal descriplion) <br />Phone/E-mail yz�� V —�C��!�i <br />City/State/Zip e�-�j� �/(,�� � Z�� <br />� K L & I Lic. # .�3Z �� ' DO % <br />�Phone/Email (fJ� � '1 G,� /��( <br />O ERMIT / <br />�.e 2 - /�-`cc�5 k-�-- <br />� ' Z� 73 / � <br />PRICE OF WORK. 2(_'),..,��%,� O, <br />Existing Use of Building �' /�5� HEAT SOURCE: <br />Proposed Use of Building_ Q��—' -e- � Gas_ Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family i�Commercial <br />Type of project: _ New _ Addition _ Remodel _ Repair LC T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />Description of Work (additional space provided on the back) : <br />�")a ` -�x��S�s�rc,►L.Lv(-`-✓�-js`�-�� � a.eewu�,t,�o�~fe- N.n�,c) Ux�� <br />a,K� y' s� y-�.- u��✓'e��. <br />Have you started workin ith t a perm�t? _YES _NO <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Aiteration _Repair Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures Show Number (#J of fixtures <br />A/C - air handling units ; Toilet <br />i Forced air systems i Bathtub <br />Gas piping Lavatory (wash basin) <br />! Water heater Shower <br />; Gas fireplace i Kitchen sink & disposal <br />{ Gas ranqe ; Dishwasher <br />Kange hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />� Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <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 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 pertorm the work for which application i e and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />� ,,, 1 v `c� "� <br />Ow uth ri d A t nature Date (Revised 2/2011) <br />0 <br />`�� <br />, <br />