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PERMIT APPLIeATION <br />BUILDING / MECHANICAL / PLUMBING / SI�N / SPRINKLER / DEMOLITI�N <br />CITY OF EVERE fT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 I FAX 425-257-8857 I(E) everetteps@everettwa.gov � wvwv.everettwa.gov/permits <br />PROJEGT SITE INFORMATION <br />PROJECT SITE ADDRESS: - �. �� PROPERTY TAX #: <br />� <br />LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />I BUILDING PERMIT APPLIGATIOPI � <br />Existinq Use of Bui <br />Proposed Use of Building: <br />Building Type: ❑SFR-Detached ❑SFR-Attached <br />Type of Project: ❑New ❑Addition ❑Remodel <br />DESCRIPTION OF WORK: <br />S�� �- <br />OCIAT�D BUtLDING PERMtT # (if applica <br />� <br />� <br />Contract Price of Work: $ <br />Heat Source: ❑Gas <br />lex ❑Multi-Family-# of Units: <br />❑T.I. ❑Sian ❑Sprinkler � <br />❑Electric ❑Other <br />❑Commercial ❑Industrial <br />$�Demolition ❑Chan4e of Use <br />�a S-t`v� G� S� �� �'�-��LE \e S S <br />--��� �� p � � � � e s � �1��, � S ���� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _ Addn _Alteration _Repair <br />Fixtures List of Fixtures Fixtu es List of Fixtures <br />A/C — Air Handling Units Heat Pump <br />Forced Air Systems Unit Heater <br />Gas Piping Boiler <br />Water Heater Refrigeration <br />Gas Fireplace Wood Stove <br />Gas Range Ducting <br />Clothes Dr er Hookups Other: <br />Range Hood <br />Exhaust Fan <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br /># of Lisi of Fiztures #°f List of Fixtwes <br />Fixtures Fixtures <br />Toilet Backflow Preventer (Inside Bldg) <br />Bathtub Urinal <br />Lavatory (Wash Basin) Drinking Fountain <br />Shower Floor Drain <br />Kitchen Sink & Disposal Grease Trap <br />Dishwasher Roof Drains <br />Clothes Washer Medical Gas <br />Water Heater Other: <br />Sink (Service/Bar/Mop/etc.) Other: <br />ACKNOWLEDGEMENT I have reviewed this application and confirm the information confained herein is true and correcL Work done pursuant to this permit must comply with <br />current federal, state, and local law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations musf first be authorized in writing irom the <br />Building Official before being authorized under any circumstance. I am the owner, or I am authorized by the owner o( this property to perform the work for which application is made. <br />and l compry with the State Contractors Law 18.27 RCW and 296 200A WAC. <br />Agent Sig <br />City o( Everetf Official Use Only <br />PERMIT # <br />� — /,5 � f,c1 f � � — U <br />Date (Revised 10/12/2015) <br />