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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: 3�o -VV-r--,y\00 IZ�, C n��2/ROPERTY�Z Anne t ZM P I C ( ., <br />LEGAL for <br />63'3 <br />new <br />1 construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br />OWNER ' P'NlCJIJ �-Of- `��E L kP1U4 0&-,() Phone/E-mail <br />Address S lfo Wzl.�k Le City/State/Zip <br />CONTRACTOR��GI.Slicrl�. �L(YC �ffE� CSO�R L & I Lic. # <br />Address �o ♦�v� ��� '� 5�� 4�� p� Phone/Email - � <br />TENANT BUSINESS NAME ICONTACT FOR PERMIT <br />I(Phone/E-mail b � N, Q� <br />BUILDING PERMIT APPLICATION ICONTRACT PRICE OF WORK $0� <br />Existing Use of Building $ ,�-Nk I HEAT SOURCE: <br />Proposed Use of Building S Q �i ZAP, N(f-c� f\%JSX-r3 G Gas Electric_ Other_ <br />Building type: XSingle Family _Duplex _Townhouse _ Multi -Family Commercial <br />Type of project: _ New Addition _ Remodel Repair _ T. I. _ Sign Sprinkler —Demolition—Change of Use <br />Description of Work (additional space provided on the back) : <br />(Have you started working without a permit? YES k NO <br />111 MECHANICAL PERMIT APPLICATION <br />Type of Project: New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C – air handling units <br />Forced airs stems <br />Gas piping <br />Water heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Range hood <br />Exhaust fan <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />I PLUMBING PERMIT APPLICATION I <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 />Sink (service/bar/mop/etc.) <br />Urinal <br />Drinking Fountain <br />Floor drain <br />Grease trap <br />Roof drains <br />Medical Gas <br />Other: <br />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 type 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 provision 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 perfoo-w f work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />Ow �gnature Date (Revised 2/2011) <br />1/-z-, <br />