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' r <br />PERMIT APPLICATION <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 />SITE ADDRESS: PROPERTY TAX # P RMIT # <br />" '' ' ' % - �� � �-, ,;Z � f%�>�, <br />LEGAL for new construction: Short PlaVsubdivision__________ __ __ ___________Lot No._____ (attach copy of long legal description) <br />> ,_ - . <br />OWNER'��� —a��l ` �. j '-��� �,1.� , ' ��7 `1C � Phone/E-mail <br />Address � � f � � �,5�'S �E" �-_. City/State/Zip ��,�,t��'�- (., ,� � _ "�(,,�''� <br />CONTRACTOR "\ ' �r�r'� t � G' - L & I Lic. # �"1' r' " � y,� <br />Address ��- �I V l,: C� _ � ' ,- �; C_�'. � �' y �C�- Phone/Email �.- � ����� <br />TENANT BUSINESS NAME CONTACT FOR PERMIT ;�, � <br />3`�} �+ ���-� C-� -' � r j-� � <br />'���' !,/�, l.; ��y��� `'i-�"����✓i��(' 1 (, !�__ Phone/E-mail �; �- .�� / � � �� - <br />BUILDING PERMIT APPLICA ON CONTRACT PRICE OF WORK���`�____________________ <br />Existing Use of Building ________________________ HEAT SOURCE: <br />Proposed Use of Building________________________________________ Gas____ Electric____ other_ __ <br />Building type: ___ Single Family ___ Duplex ___Townhouse ___ Multi-Family .✓'�ommercial <br />Type of project: ___ New ___ Addition ___ Remodet ___ Repair ___ T.I. �°iSign ___Sprinkler ___Demolition___Change of Use <br />DesCription of Work (additional space pr�vi�led on the back): <br />, t t" !' - -. <br />� _ <br />� ��1� ) �'�L.r �.�,;�,� � `,'` i (`�_ - {::�� � JZ= ,. <br />Have you started working without a perenit? ____YES _s__NO <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _ _New ___Addn ___Alteration ___Repair Type of Project: ___New ___Addn ___Alteration ___Repair <br />Show Number (#J of fixtures Show Number (#) of fixtures <br />� A/C — air handling units ; Toilet <br />Forced air systems ' Bathtub <br />� Gas piping Lavatory (wash basin) <br />i Water heater � Shower <br />! Gas fireplace Kitchen sink & disposal <br />, Gas range Dishwasher <br />I Clothes dryer Clothes washer <br />i Range hood Water heater <br />Exhaust fan ; Sink (service/bar/mop/etc.) <br />Heat pump � ' Backflow preventer <br />I Unit heater Urinal <br />� Boiler � ' Drinking Fountain <br />� Refrigeration I ; Floor drain <br />� Woodstove i Grease trap <br />! Ducting Roof drains <br />I Other________________ ; Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM i Other: <br />� Number of Heads I Other: <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing <br />this typ of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel <br />the pr ��ion of any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to p j�;4✓ork for'which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />_� .. <br />%, � � `,`, � �' �/ .' <br />Ow er/Authorized Agent Signature Date (Revised 2/2011) <br />- � 1 z. <br />� <br />