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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 />ADDRESS: �f �f �j ,� PROPERTY T[A.�X # PERMLT # n �] /j <br />�7 � L% `� 'Z�.;' f- L iC�L�/'LI� / ��/'. l�/-='L ( � �: /� .7 `� �-' � / �^ ! E i' � L� �/(l / �C/� <br />EGAL for new construction: Short Plat/subdivisi <br />OWNER � � <br />Address � �'� j <br />CONTRACTOR <br />!• ; �i � .�'r ,S..SjI%� <br />d✓�t�=�� /L ��� �/%a <br />v z=' .iG' F `=-� <br />Hdaress <br />TENANT BUSINESS NAME <br />BUILDING PERMtT APPLICATIOfd <br />Lot No. (attach copy of long legal description) <br />Phone/E-mail �',� yj� ,� " ��.5�% '- l � � � <br />L&ILic.# <br />IPhone/Email <br />ONTACT FOR PERMIT <br />ONTRACT PRICE OF WORK <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi-Family <br />Type of project: _ New _ Addition _ Remodel _ Repair _ T.I. _ <br />DesCription of Work (additional space provided on the back) : <br />� �;�,1 �;� � /r° t=i:� �� 9 �' <br />Have you started working without a permit? _YES _NO <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 />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 />Refriaeration <br />( Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />Gas Electric Other <br />_ Commercial <br />Sign _Sprinkler _Demolition_Change of Use <br />��s�' -�.� z <br />� 7���� � � ' <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />� Toilet <br />Bathtub <br />� Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />j Water heater <br />Sink (service/bar/mop/etc.) <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 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 />,'�% ,;� r;' <br />71 <br />�`f�e � � - ��-�-�� :_----. _ �—. <br />Owner/Authorized Agent Signature Dat Revised 2/2011) <br />CV'�C t <br />