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• • <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 ADDRFRS: PROPERTY TAX# MIT <br /> tC I kx- , e- Zl <br /> LEGAL for new construction: Short Plat/subdivision Lot No. / (attach copy of long legal description) <br /> OWNER ��Qv(`��kL�NId C'vc�C�/ ��E.� 6� v✓v�S Phone/E-mail kdc <br /> Address /Npr V Stu-) U k- City/State/Zip �Ve,Vr� '^'� lb'2o <br /> i <br /> CONTRACTOR L�Lr^ Pt�l `� ZT� L&ILic.# \fp.�SSI�'ZZCj Lr�L' �wZ`3SS <br /> Address (227 �C t(7t.L AlJ (f Li`jt(.16L j Phone/Email T25`252_311 <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> t ✓(G!' j 7cFf yleCr' P't;4-W s' Phone/ mail l Z S -2-51­3(14 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /0 r 3Dy <br /> Existing Use of Building ('0Aci{,t HEAT SOURCE: <br /> Proposed Use of Building fP COQ f Gas_ Electric Other_ <br /> Building type: _Single Family _Duplex—Townhouse _Multi-Family k Commercial <br /> Type of project: _New _Addition _Remodel K Repair_T.I._Sign_Sprinkler—Demolition—Change of Use <br /> Description of Work(additional space provided on the back): <br /> (ZC P LACC- un,, Ott{ —A 3 )a,&,6 T) c,j(e,66 i460 <br /> Have you started working without a permit? _YES K NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration KRepair 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 I 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 /> to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> eVvrrffMuthoF!f4Agent Signature Date (Revised 2/2019) <br />