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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: %A / �� ^ I PROPERTY TAX# PERMIT# <br /> i , NLEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNERG L L 'F /q/jli(/� •� Phone/E-mail Z 7 Z Z Z,3 <br /> Address Vff— City/State/Zip (.- /J wpq qS <br /> CONTRACTOR jp/t% - )L-fi L& I Lic.# <br /> Address )0 L . + 6 i LL A06T Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building 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.1._Sign_Sprinkler_Demolition_Change of Use <br /> Description of Work(additional space provided on the back): / <br /> C l L <br /> Have you started working without a permit? OYES 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 Other: <br /> I hereby certi 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 wi 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 provisi f anyther ate or local law regulating construction or the performance of construction.That I am authorized by the owner of this property <br /> to perfor t w rk f r ch application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> Owne thori en ignature Date (Revised 2/2011) <br />