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� <br />� <br />� <br />PERMIT APPLICATIOI <br />BUILDING / MECHANICAL / PLUMBING / SIGN / SPRINKLER / 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@everettwa.gov � www.everettwa.qov/permits <br />� BUILDING PERMIT APPLICATION I <br />Existing Use of Building: M2dICel OffC@ Contract Price of Work: $ 125,000.00 <br />Proposed Use of Building: MedIC81 OffICe 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 ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />DESCRIPTION OF WORK: Se@ AttaChed <br />�ASSOCIATED BUILDING PERMIT # (if applicable): <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New Addn Alteration Repair <br /># of List of Fixtures # of List of Fi�ctures <br />Fixfures 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: 1 have reviewed this application and confirm the informafion contained herein is true and correct. Work done pursuant to this permit must comply wdh <br />current federal, state, and local law. The granting o(a permit only autho�izes approved work and no deviations therelrom. Deviations must first be authorized in writing (rom the <br />Building Official be(ore being authorized unde� any circumstance. 1 arn the owner, or I am aufhorized by the owner of this property to per(orm the wnrk for which application is made, <br />and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br />�-:�R� <br />�►�-L� <br />City o! Everett Official Use Only <br />PERMIT # <br />� � � I '� � �d <br />ate (Revised 10/12/2015) <br />�1z <br />