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• <br />• <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 # P RMIT # <br />���� �E�=1�1� ��x���`'l(� �- � l C i f�y," <br />LEGAL for new construction: Short PlaVsu <br />OWNER <br />l� 2. ( Cb C.�Y A�! � <br />ONTRACTOR <br />�F'�'��(rt7E�1GG �f-fY:>&�I�'.(:=� .:�#z�U� <br />a�,l d,�� �1 <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building �•2. 1-�0�.7��QU <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail <br />City/State/Zip ��� ���T, �:� ���''L�' � <br />L&ILic.# <br />Phone/Email <br />)NTACT FOR PERMIT �Y�N S,�Y�-�z. <br />one/E-mail �'1.�''�.�.��•��o8%Gie�!(t"1�'r7t'(�t�G�. <br />)NTRACT PRICE OF WORK ���7� DDD , DD <br />HEAT SOURCE: <br />Proposed Use of Building �•'Z- (-?��'�-' �s L[ h( i�� I Gas� Electric_ 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 />Description of Work (additional space provided on the back) : <br />-ri-�� -�.r.�»r it.�vaLvcs -r: t . �-�:r��. u� �xc�-t�r�, -�H�L. -�-�,�_-� ,�c�� <br />�Xc�-t7 t�-L� G�.G N l c. .�/aGc� ar-� -M� ��"' � l_c;e;' �- . <br />Have you started working without a permit? _YES �NO <br />MECHANICAL PERMIT APPLICATION <br />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 />Gas fireplace <br />� Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />—� Woodstove <br />Ducting <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I Toilet <br />Bathtub <br />Lavatory (wash basin <br />Shower <br />Kitchen sink & dispos <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/moK <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 />Z' <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 de and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />,�---� <br />� ` , <br />wner/Authoriz Agent Signature Date (Revised 2/2011) <br />