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�ERMIT APPLICATIO�
<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 />ADDRESS: �-y ---. , ; � - , � _ � �., PROPERTY TAX # PERMIT #
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<br />�L for new construction: Short PlaUsubdivision � Lo�No. (attach copy of long legal description)
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<br />APPLICANT: �/ Owner _ Owner's Agent
<br />CONTRACTOR
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<br />Contractor
<br />BUILDING PERMIT APPLICATION
<br />Existing Use of Building '.U2�!� ':-r�` �_` ' �
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<br />L&ILic.#
<br />Phone/Email
<br />Phone/E-mail
<br />CONTRACT PRICE OF WORK
<br />COE Bus. Lic. #
<br />HEAT SOURCE:
<br />Proposed Use of Building ✓�C} ``���'` ,r<�- � Gas Electnc Other
<br />Building type: _ Singfe Family �fDuplex _Townhouse i,� 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 provrded on the 6ack) f' `����� ` � r , /,-, � � ;�,� f , � , ,: r' v � �7` '>'�`,[�
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<br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION
<br />Type of Project_ _New _Addn _Alteration _Repair
<br />Show Number (#) of fixtures
<br />A/C — air handling units
<br />Forced air systems
<br />Gas piping
<br />Water heater
<br />vas rirepiace
<br />Gas range
<br />Clothes dryer
<br />Range hood
<br />Exhaust fan
<br />Unit heater
<br />Other
<br />► SUPPRESSION
<br />Number of Heads
<br />Type of Project: _New _Addn _Alteration _Repair
<br />Show Number (#) of �xtures
<br />Toilet
<br />Bathtub
<br />Lavatory (wash basin)
<br />Shower
<br />Kitchen sink & disposal
<br />Dishwasher
<br />Clothes washer
<br />Water heater
<br />Sink (service/bar/mop/etc.)
<br />Backflow preventer
<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 We and correct. All provisions of laws and ordinances goveming this type of work will be complied
<br />with whether spec�ed herein or not. The granting of a pertnit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction
<br />That I am authorized by the owner of this property to pertorm the woric for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC.
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<br />Owner/Author�� nt Signa u� �� 1 Date y (Revised 6/2012
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