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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 />Co�.SuYld APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��' "'j � <br />TE ADDRESS: �O i:i ;, PROPERTY TAX # PERMIT # <br />�i"�l i ��' . .. =/ . �! �Yt'�� / /=� :/, :?`-'.n . - r % _ _ - <br />LEGAL for new construction: Short PlaUsubdivision. <br />i- <br />OWNER -;',.�, � � r'.� ,._ �..� , - <br />Haaress <br />CONTRACTOR :". �'� ;,_ � �d : i � f � +-� _ � �'r�_ <br />Address ,;� EG.��' r'+� �� �K K!� i��� <br />: �; �`.�. " - <br />BUILDING PERMIT APPLICATION <br />No. (attach copy of long legal description) <br />Phone/E-mail <br />City/State/Zip <br />L & I Lic. # C ✓"i � /-� ��- 9�0��r � <br />: ��';, f..= r- � C %!f C �F! 1. Z'i �s (l� Y % �.=. �. <br />Phone/Email <br />CONTACT FOR PERMIT <br />�� , <br />PhonelE-mail �� '� Y— � j�j �vr,� C� � t G� 7 <br />CONTRACT PRICE OF WORK <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas_ Electric_ other_ <br />Building type: _ 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 Work (additional space provided on the back) : ,�`�. <br />. ,� S'4 � �. �13�CN V' ✓^'�. 1-� 6� <br />' �j�� �'� � �. vr.� - i-1 Z`'-4 t: <br />�, � ; - � ;�, <br />,�,� .�-;1�,: v � <br />Have you started working without a permit? YES _NO <br />MECHANICAL PERMIT APPLICATION PLUMBING 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 />� Gas piping <br />Water heater <br />i Gas fireolace <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />SPRINKLER / SUPPRESSION SYSTEM <br />�G-'�,� � � Number of Heads <br />of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />I Toi�et <br />Lavatory (wash <br />Shower <br />Kitchen sink & c <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bz <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 vyhich app�ication is made and I comply with lhe State Contractors Law 18.27 RCW and 296200 WAC i/� <br />r ( <br />�� /' r �-` . , \ �( �. -� r�' J'Qr'��! •. � �---- <br />Ow`ner/ uthorized Agent Sig"nature Date (Revised 2/2011) <br />