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i <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everetl, WA 98201 -425-257-8810-FAX 425-257-8857-www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM �`�2I `-' � <br /> SIT DDRESS: � VROPERTY7AXN PE � . <br /> I <br /> IEGAL ta new construction: Snoh PlaUsubdrvision Lot No._ (attach copy ot long legal tlescription) <br /> OWNER � Phone/E-mail �/� <br /> tltlress Q QQ C p '�" w City/StatelZip Q����/(,� w <br /> CONTRACTOR £ � ' SGr✓� L&I Lic.# � D 5 W <br /> tltlress ����� L "1 � f Wfl honelEmail �06 -6 7 - S6 Y <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT � '/�3 <br /> ,�I �(C� P�one/E-mail y <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use oi 8uilding HEAT SOURCE: <br /> Proposed Use ot Building Gas_ Electric_ Other_ <br /> Building rype: _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 WoAc(additional space providedon the back):, � <br /> ap�� .,�do� wu� ,�oy 7z µ+ �kbble d�. Anc� Petfc{�inq w� <br /> Nave you started working without a permitT _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJact: _New_Addn _Attentio�_Repalr Type of Projeet: _New_Addn _Allentlon_Repair <br /> Snow Number(N)o/�xtures Show Number(N)o/pxtums <br /> A/C—air handling units Toilet <br /> Forced air systems Balhtub <br /> Gas pipin Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas ran e Dishwasher <br /> Clothes drver Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink service/badmopletc.) <br /> Heat pump Backflow reventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration � Floor drain <br /> W oodstove � Grease trap <br /> Ducti Roof drains <br /> Other Medical Gas <br /> 8PRINKLER/ SUPPRE8SION SYSTEM Other: <br /> Number of Heads Othec � <br /> I hereby certiry that I have read antl examined this application and know Ihe same to be true and wrt�ct.All provisions of laws and ortlinances goveming <br /> this type of work will De comD�ieal with whether speci(ed�erein or nol.The granting of a permit Ooes nct presume lo give authodry to viWale or cencel <br /> t�e provision of any other state or local law regulating constructlon or t�e paAortnance of construction.Thal I am auMorfzeC Dy the owner ot Mis propeAy <br /> to peAorm Ihe work for which application is mada and 1 compy wilh the State Coniredors Lew 1827 RCW enA 298.200 WAC <br /> OwnsrlAuthmized Agent 3lgnaWro Date (f2evised7/2017) <br />