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�ERMIT APPLICATIO� <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 />ITE ADDRESS: ��' PROPERTY TAX # PERMIT # <br />�%�/ (�mc�-s�� � � �03— � i, <br />LEGAL for new construction: Short Plat/subdivision <br />OWNER � fC�j�� <br />Address %�� �(.<'" �/ <br />APPLICANT:i� Owner <br />ONTRACTOR <br />Owner's Agent <br />Lot No. (attach copy of long legal description) <br />� !�� Phone/E-mail <br />� City/State/Zip 1���� � ^' �G � � ���� <br />� <br />Contractor _ Contractor's Agent _ Tenant U�ust provide a letter or consent rrom tne owner to do work in the space) <br />BUILDING PERMIT APPLICATION <br />L& I Lic. # COE Bus. Lic. # <br />Phone/Email <br />CONTACT FOR PERMIT ( l,v� t—/ti�LG <br />Phone/E-mail <br />�aS- 3 �S' �/ �� <br />CONTRACT PRICE OF WORK Cflw• �� <br />Existing Use of Building ��� �✓� <br />Proposed Use of Building S;%� <br />�� ���� <br />Building type: � Single Family _ Duplex _Townhouse _ Multi-Family <br />Type of project: New Addition Remodel Repair _ T.I. <br />DESCRIPTION OF WORK (additional space piovided on the back) : <br />,�.�� r-��� �'��-`� <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: New _Addn _Alteration _Repair <br />Sho Number (#) of fixtures <br />� A/C — air handling units <br />,�� Forced air svstems <br />1/� ter heater <br />Gas ireplace <br />Gas r ge <br />Clothes er <br />Range hoo <br />Exhaust fan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />� Gas_j� Electric Other_ <br />_ Commercial <br />Siqn Sprinkler Demolition Chanqe of Use <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 />�jnk (service/bar/mop/etc.) <br />BaCkflow preventer <br />Urin'�I <br />Drinki Fountain <br />Floor dr in <br />Grease tr <br />Roof drains <br />Medical Gas , � <br />Other: 'z <br />Other: <br />i hereby certify that I have read and examined this application and know the same to be Vue and correct. All provisions of laws and ordinances governing this type of work will be complied <br />with whether specified herein or not The granting of a permit does not presume to give authority to vioiate or cancel the provision of any other state or local law reg�tlating construction <br />That I am �thorizs e own�7nf-tMis_�roperty to perform the work for which application is made and I compiy with the State Contractors Law 1827 RCW and 296 200A WAC. <br />-- 1 —7 .> � � � <br />,� , -- i _�/�/�' <br />Owner/Authorized Agent Signature Date (Revised 6/2012) <br />