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�� �� <br />I�►� � - <br />� <br />PERMIT APPLICATIO�' � <br />BUILDINt� iMECHANICAL / PLUMBING / SIGN I SNRINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everetteps(c�everettwa.qov � www.everettwa.clov/permits <br />PROJECT SITE INFORMATION <br />PROJECT SITE ADDRESS: Z � S (� (�Si, � PROPERTY TAX #: L�� � j� �v ZO !��� <br />LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: Contract Price of Work: $ 3(�c� 0 <br />Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br />Building Type: ❑SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units: Commercial ❑Industrial <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair .I. ❑Sign ❑Sprinkler ❑Demolition ❑Chan e of Use <br />DESCRIPTION OF WORK: <br />�'GQ �'` �—��' ��YcScS L� <br />� � <br />ASSOCIATED BUILDING PERMIT #(if applicable): �"� ��1 li 1� rj ')� <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br /># of List of Fixtures # of List of Fixtures <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 8� 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 correct. 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 the�ef�om. Deviations must first be authorized in writing from the <br />Building O(ficial before being authorized under any circumstance. I am the owner, or I am authorized by the owner of this property to periorm the work for which application is made, <br />and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />� City of Everett Offlcial Use Only <br />� /'� �� PERMIT # � � � ^ �. �� <br />L <br />horized Agent Signature Date (Revised 10/12/2015) <br />