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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 ADDRES�S7: j� (' 11 �Ir1 PROPERTY TA7X2 # �RM'"`�T#7� C'� <br />� U ��U L��� 1/� �C. �:vr� C,"t� .�V Y1 C��ZGO �'�'��%4"7�',��%������l�J 1�l1 O�l�� "��.�/ <br />LEGAL for new construction: Short PlaUsubdivision <br />.� 1 r I <br />OWNER � Gn,v C�,nd l,�r'�S�US Oc�n�}� i, <br />Address � �' � ��' ��+�� �✓ �� <br />CONTRACTOR �% �1e� <br />Address <br />TENANT BUSINESS NAME <br />BUILDIPlG PERMIT APPLICATIOl�1 <br />Lot No. (attach copy of long legal description) <br />Sr/, Phone/E-mail <br />City/State/Zip <br />L & I Lic. # <br />CONTACTI <br />Phone/E-mail <br />Phone/Email <br />ONTRACT PRICE OF WORK <br />r� <br />Existing Use of Building �� ��n�l i �i � ,s f2 HEAT SOURCE: <br />Proposed Use of B�uilding �iri'MGt✓�/ 1 d�'1C-c% Gas_ Electric Other <br />Building type: ✓Single Family _ Duplex _Townhouse _ Multi-Family _ Commercial <br />Type of project: _ New _ Addition i�Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />Description of Wofk (additional space provided on the back) : L�: ,r,��r�-�I ��, �,�, �' 1�( l U� b�,,C �' `/G�✓� � k„��,,k � S <br />. �!.' b U',' �d � � � � ( G�✓ � � <br />�onn �'.� � oc,�� v-E , Q IC..r� �iro lc�'',t,c,� d r� �- c 1 lj �! l2 , n 5�, ZG . 17t�� � s'12' �'., h�i' v� h%. <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 />j 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 />Refriaeration <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 !#1 of fixtures <br />Bathtub <br />Lavatory (wash basin <br />Shower <br />Kitchen sink & dispo� <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/moF <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 perf rm the rk for which a li ation is made�nd I comply with the State Contractors Law 18.27 RCW and 296.200 WAC �� <br />� � ("L f� � z <br />n Authorize Age Signature Dat (Revised 2/2011) <br />