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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 />ADDRESS: ' PROPERTY TAX # P� RMIT # <br />; ��_� C�, C'��>�✓o l�� . `I-�l1�J-vl' <br />LEGAL for new construction: Short PlaUsubd <br />OWNER r�C'� I �,' (-, <br />Address <br />CONTRACTOR �� � � <br />ress <br />� -�--G n <br />Y��i� l r1 (� <br />BUILDING PERMIT APPLICATION <br />No. (attach copy of long legal description) <br />Phone/E-mail <br />L & I Lic. # <br />Phone/Email ^� ��, D �y � � �j � � <br />CONTACT FOR PERMIT <br />_�-,� <br />�'% �. >-, (1 �, iz_ j l� l <br />Phdne/E-mail <br />CONTRACT PRICE OF WORK ��aJ �� ��L; �� � � <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building 1���'�� rE t"��T ��' (' TYt�/� � M(�N ' (��"� �'' Gas__ Electric Other <br />Building type: Single Family _ Duplex _Townhouse _ Multi-Family %� Commercial <br />Type of project: J� New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />DeScription of Work (additional space provided on the back) : r „ � <br />��c7��� %/Yt-. U r�l� /'`1U GJ (,./ �J- J%� l,/U�% E�2— �I Yl,�/�'� w� ��� 1 ��- C�r1 i <br />Have you started working without a permit? YES x NO <br />MECHANICAL 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 />Gas fireplace <br />� Gas range <br />Clothes dryer <br />Rangehood <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Refrigeration <br />Woodstove <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 (#) of fixtures <br />� Toilet <br />Bathtub <br />Lavatory (wash basin) <br />Shower <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Water heater <br />Sink (service/bar/mop/etc.l <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 p orm the work for which applicati is made and I comply wit the State Contractors Law 18.27 RCW and 296.200 WAC <br />�'v�v--� ��"I,�i� � � �� �� i <br />�/ <br />ner/Authorized Agent Signature Date (Revised 2/2011) <br />