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%RMIT APPLICATIOP <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 ADDRE55: YG _ ` . _., PROPERTY TAX# P_FqMIT# <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> 4 aT_ <br /> OWNER � Phone/E-mail <br /> Address City/State/Zip <br /> CONTRACTOR L& I Lic. # i X11�j ' I <br /> Address , Cl ehZCA Phone/Email q <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> 4-0) <br /> Phone/E-mail `kms` \ —as C) <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK -7L" <br /> Existing Use of BuildingAPM, 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 o7ftfte back) <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 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 Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> _ Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> _ Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other <br /> Number of Heads <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 cDjnp}igd 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 ofs 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 to tvi application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> Owner/Authorized Adpoesignatu a ate (Revised 1212010) <br />