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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 wuvw.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS:;s7^� � ��� , PROPERTYTAX# P RMIT,#�O � O� <br /> . <br /> G4'�� � <br /> LEGAL for new construction: Short PlaUsubdivision Lot No. (attach copy of long legal description) <br /> OWNER �.l�"' �'i�!-,'r Phone/E-mail�C�" I�•ZG`(c,�) '✓�(: �w/I j{�. C�., <br /> Address '� City/State/Zip ,�ii�'�(� CS� <br /> APPLICANT:_Owner _Owner's Agent _Contractor _Contractor's Agent _Tena�t�mus�Provwe a�etter or consent rrum me ovmer eo ao wo�c i�me sPaceJ <br /> CONTRACTOR ���Yu� I��►�,4-j�t?.� L&I Lic.# �!(�'�� ��' ���� COE Bus. Lic.# <br /> Address ,��f� Phone/Email �F <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail -�A1'I`=— <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK :3752'��:1;c.� <br /> Existing Use of Building S+�l�i �� �''�� '/ HEAT SOURCE: <br /> �, � <br /> Proposed Use of Building Gas_ Electric_ other <br /> Building type: �Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New 7�Addition Remodel Repair_T.I._Sign_Sprinkler Demolition_Change of Use <br /> DESCRIPTION OF WORK(additional space provided on the back): �� I x. ��—i �,� n�7�,�� ������,� <br /> i�Y-c�-. <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 I Toilet <br /> Forced air s stems ! Bathtub <br /> Gas piping Lavato (wash basin) <br /> Water heater i Shower <br /> Gas fire lace i Kitchen sink&disposal <br /> i Gas range Dishwasher <br /> I Clothes dryer Clothes washer <br /> � Ran e hood I 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 Floor drain <br /> Woodstove ; Grease trap <br /> Ducting Roof drains <br /> Other i Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other: <br /> Number of Heads � Other: <br /> I hereby certify that I have read and euamined this application and know the same to be We and correct.All provisions of laws and ordinances goveming this type of work will be complied <br /> with whether spec�ed herein or not.The granting of a pertnit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br /> That 1 am authorized by the owner propeRy perform the woric for which application is made and I comply with the State ConVactors Law 18.27 RCW and 296.200A WAC. <br /> � � �S �� <br /> Owner/Authorized Agent Sigh e 1 D e (Revised 6/2012) <br /> / <br />