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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 ADDRESS: PROPERTY TAX# PERMIT# <br /> 0 N S PL E A 00006400001400 UD <br /> LEGAL for new construction: Short Plat/subdivision _Lot No. (attach copy of long legal description) <br /> OWNERJEAETT R Phone/E-mail <br /> Address 602 (N S PL A City/State/Zip (2'8203 <br /> CONTRACTOR L&I Lic.# ^ <br /> Address Phone/Email 425- 252 - r)-8 Q <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT {� G + <br /> - <br /> Phone/E-mail 0 Qd h�41� JJZS .2 ✓Z. - <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 1-C-r 1200 <br /> Existing Use of Building HO MG HEAT SOURCE: <br /> Proposed Use of Building NOME Gas_ Electric_ Others L L, <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): 701 <br /> ENL.ARPE MASTER �DQDoM 1 <br /> ADD RA-rH2coM <br /> Have you started working without a permit? _YES )C NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New V 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 /> I 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 /> fX 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 /> I Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I Other: <br /> Number of Heads I 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 /> toJn4lAuthorized <br /> m the work for which- plication is made and I comply <br /> with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> 0 Ag t Signature Date (Revised 2/2011) <br /> �� <br />