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PERMIT APPLICATIOP' <br />BUILDING ECHANICAL / PLUMBING / SIGN RINKLER / 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 />I BUILDING PERMIT APPLICATION I <br />Use of <br />roposed Use of Building: <br />uilding Type: ❑SFR-0etached SFR-Attached ❑Duplex <br />ype of Project: ❑New ❑Addit' n ❑Remodel ❑Repair <br />ESCRIPTION OF WORK: <br />� � � � � � � �� ��. <br />� <br />TED BUILDING PERMIT # (if applicabl <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: New Addn Alteration Repair <br />Fixtures Lisi of Fixtures 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 />Exhaust Fan <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Contract Price of Work: $ �jb � <br />�Heat Source: �Gas ❑Electric ❑Other <br />❑Multi-Family-# of Units: ❑Commercial ❑Industrial <br />❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Chanqe of Use <br />PLUMBING PERMIT APPLICATION <br />Type of Project: New Addn Alteration Repair <br /># of List of Fixtures # of List of Fixtures <br />Fixtures 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: I have reviewed this application and confirm the information contained herein is irue and correct. Work done pursuant to this permit must comply with <br />current federal, state, and local law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing from the <br />Building Official before being authorized under any circumstance. I am the owner, or I am authorized by the owner of this property to perform the work for which application is made, <br />and I comply with ihe State Contractors Law 18.27 RCW and 296.200A WAC. <br />City of Everett Official Use Only <br />PERNJI <br />�I���� � I <br />(Revised 10/12/2015) <br />