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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: PROPERTY TAX H PER ��a <br /> MIT# <br /> 33z. 94-1Ever4 INA"11 WA l AGI <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER NI g1-10yK1 Fiev.e rrt1 \tv,vrAhc.c Phone/E-mail <br /> Address City/State/Zip <br /> CONTRACTOR Garc cvNal Co»SNrv�A-1 L& I Lic.# <br /> Address 1 Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> ► Ghf(s `(Zc.�� yz5-Z�- c8s4% <br /> tom <br /> N A'i1 tsvuNk G Mf \ \flsvrAv,CR Phone/E-mail c..NnfiS.`l'Mtbin\ikafcl...c.z s, r� <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 4J- <br /> Existing Use of Building OA c‘'c.e HEAT SOURCE: <br /> Proposed Use of Building oc (c_< Gas Electric_ Other__ <br /> Building type: _Single Family _Duplex Townhouse Multi-Family _Commercial <br /> Type of project: New _Addition _Remodel _Repair T.I._Sign SprinklerV Demolition Change of Use <br /> Description of Work(additional space provided on the back): <br /> Have you started working without a permit? YES 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(#)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 /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove I Grease trap <br /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads 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 perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> Qcxol Z/ZZ /(P <br /> Owner/Authorized Agent Signaturate (Revised 2/2011) <br />