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• PERMIT APPLICATION • <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.gov/permits <br />I BUILDING PERMIT APPLICATION ______� <br />Existina Use of Bu <br />Proposed Use of Building: (_t!�Cv'! l <br />r <br />Building Type: ❑SFR-Detached ❑SFR-Attached <br />Type of Project: ❑New ❑Addition ❑Remodel <br />DESCRIPTION OF WORK: <br />SOCIATED BUILDING PERMIT # (if applicable <br />Contract Price of Work: $ " �JC�L' <br />Heat Source: ❑Gas ❑Electric ❑Other <br />❑Duplex Multi-Family-# of Units: � ❑Commercial ❑Industrial <br />,OFiepair ❑T.I. ❑Sign �Sprinkler ❑Demolition ❑Change of Use <br />4 � . , � � l ►��J�t,i V i � � v�-I-ev �rY {YU�,� <br />-� . �� �� I�c�,U <br />�� � <br />�,;��,� ,��- � �►� ����� v�o�ll . , � � s i�r <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _ Addn _Alteration _Repair <br />Fixtures List of Fiztures Fixtures List of Fixtures <br />A/C —Air Handling Units Heat Pump <br />Forced Air Systems Unit Heater <br />Gas Piping Boiler <br />Water Heater Refrigeration <br />Gas Fireplace Wood Stove <br />Gas Range Ducting <br />Clothes Dryer Hookups Other: <br />Range Hood <br />ExhaustFan <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />�LUMBING PERMIT APPLICATION <br />Type of Project: New Addn Alteration _Repair <br /># of List of Fixtures # of List of Fiztures <br />Fixtures Fixtures <br />Toilet <br />Bathtub <br />h Bas <br />Kitchen Sink & Disposal <br />Dishwasher <br />Clothes Washer <br />Water Heater <br />Sink (Service/Bar/Mop/e <br />Backflow Preventer (Inside <br />Urinal <br />Drinking Fountain <br />Floor Drain <br />Grease Trap <br />Roof Drains <br />Medical Gas <br />Other: <br />Other: <br />ACKNOWLEDGEMENT: I have reviewed this application and confirm the information contained herein �s true and correct. Work done pursuant to this permit must comply with <br />currenf federal, state, and /ocal law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing (rom the <br />Building Official before being au e nder any circumstance. I am the owner, or I am authorized by the owner of this property to perform fhe work for which application is made. <br />and 1 comply with the State ntracto Lay✓ 18.27 RCW and 296.200A WAC <br />�z-��-is <br />OwnerlAufhorized Agent`3ignature uate <br />Ciry of Everett Official Use Only <br />PERMJ,T # � <br />�� ' <br />(Revised 10/12/2015) <br />� /a <br />