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• <br />L� <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 �{DDRESS: � ;-� PROPERTY TAX # PEIjMIT # <br />� 5 I "Z `l�.i 1 r7�'v� /�lr-� • v r �� � ` : � � � � (.) � j - (.�. <br />LEGAL for new construction: Short Plat/subdivision <br />OWNER ���i e i-. {-'C�1�1/i � ^I'�-� <br />1/ . /� <br />Address S 3. C' GV ��jf�`-cY1 <br />CONTRACTOR : �2---'v�-� r�' <br />Address <br />TENANT BUSINESS NAME <br />�jc ` � <br />BUILDING PERMIT APPLICATION <br />� <br />Lot No. (attach copy of long Iegai description) <br />Phone/E-mail 7(..` �• ZG� � (� z 2 <br />ity/State/Zip <br />L&ILic.# <br />NTACT FOR PERMIT <br />� \ <br />ne/E-mail !�c..c_,� ��J � _ � 3 Z Z . <br />NTRACT PRICE OF WORK '�.� �+ .. � <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas_ Eiectric_ 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 />Descfiption of Work (additional space provided on the back) : <br />-� <br />if�'�,� 1 �..�,,,�c,w-- �"',�2-��c� �d/�v!,l�rti,J O� .2G�r L����c(�i���,.... <br />Have you started working without a permit? _YES =N0 <br />MECHANICAL 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 />i Water heater <br />� Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />� Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />� Refrigeration <br />� Woodstove <br />I Ducting <br />( Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />5 Z- <br />PLUMBING PERMIT APPLICATION <br />of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />I Bathtub <br />Shower <br />Kitchen sink & disp <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/m <br />Backflow preventer <br />Urinal <br />Drinking Fountain <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 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 Iaw regulating construction or the performance of construction. That I am authorized by the owner of this property <br />•� to pertorm the}n�Tor which application is made and I comply with the tate Contractors Law 18.27 RCW and 296.200 WAC <br />�. .` . r _ ._ _ ._ ._ ... <br />� .,_ �Z�f <br />`� `,: �� .____-- Z <br />•� Owner/Authorized Agent Signature Date (Revised 2/2011) <br />�/Z <br />