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PERMIT APPLICATION <br />• <br />�IJILDING/MECHANICALlPLUMBING/SIGN/SPRIN�LER/DEMOLITION <br />G!TY OF EVEPETT' R�RMI i ��r^�1iICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />SITE ADDRESS: <br />ROPERTY TAX �# <br />LEGAL for new construction: Short Plat/subdivision y <br />Lot No. <br />OWNER <br />Address <br />APPLICP.NT: Owner <br />CONTRACTOR `(� <br />Address � gO> <br />TENANT BUSINESS N� <br />�v� Zd <br />Owner's Agent � Contractor <br />Phone/E-mail <br />City/State/Zip <br />(attach copy of long legal description) <br />V �� <br />Contractor's Agent _ Tenant �m�st Pro��de a iEt;er of consent frem the o.:�er to do work in thz spzce) <br />State Lic. �` <br />` � � � iSiione/Emzil <br />E CONTACT FOR PER <br />�es5lco, '� <br />Phone/E-mail !�%�•L <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building <br />CONTRACT PRICE OF WORK <br />Proposed Use of Building <br />6uilding type: _ Single Family _ Duplex _ I ownhouse _ Multi-Family <br />Type of project: New Addition Remodel Repair T I <br />DESCRIPTION jF WORK (additr�l spaCe provided on the back): <br />� � � �,-e s <br />�ioco�.� C,�2� �ea�ss <br />MECHANICAL PERMIT APPLICATIORJ I� <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixEures <br />� A/C — air handlinq units <br />� Forced air s stems <br />�_ Gas pipinq <br />� Water heater <br />� Gas fireplace <br />� Gas ran e <br />� Ciothes d er <br />�_ Range hood <br />� Exhaustfan <br />_ � Heat pump <br />� Unit heater <br />� Boiler <br />� Refrigeration <br />� Woodstove <br />� Ductina <br />SPRINKLER / SUPPRESSION SYSTEM <br />� Number of Heads <br />G <br />Commercial <br />n �Sprinkler <br />'j'�Il�-City Bus. Lic. # tj� <br />� iui� � . <br />_�L� V <br />� <br />E <br />� 5� SOd. � <br />HEAT SOURCE: <br />Electric Other <br />molition Change of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _qlteration _Repair <br />Shovr Number (#J of fixtures <br />I Toilet <br />� Bathtub <br />�_ Lavatory (wash basin) <br />� Shower <br />�_ Kitchen sink & disposal <br />� Dishv✓asher <br />� Clothes washer <br />� Water heater <br />� Sink (service/bar/mop/etc ) <br />� Backflow preventer (inside bid ) <br />� Urinal <br />�_ Dnnkinq Fountain <br />� Floor drain <br />� Grease trap <br />� Roof drains <br />I Medical Gas <br />IOther: <br />IOther: <br />� CfD1a'� <br />�o� <br />I hereby certify that I have read and examined this application and know the same to be true and correct. Ali provisions of laws and ordinances goveming this (ype of work will be comp <br />with �vhether specified herein or not. The granting of a permit does not presume to give aulhority to violate or cancel the provision of any other state or local law regulating conslruction <br />That I uthorized by the owne is propeRy to perform the work forwhich application is made and I comply with the State Contrac[ors Law 18.27 RCW and 296.200A WAC. <br />- D! � <br />wn /Authorized Agent Signature Date <br />(Revised 4/2015) <br />