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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITI N <br />�' <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: . G/ <br />PROPERTY TAX# <br />E MIT a_ <br />D �► <br />LEGAL for new construction: Short Pla subd lslon Lot No.—(attach copy of longg1 legal description) <br />jj <br />'Jd <br />OWNER <br />Phone/E-ma'll <br />Address <br />I' <br />4 <br />f,�j'2 <br />'-I' <br />City/State2ryt� ve re. yV 2 0 <br />CONTRACTOR JqJ3 <br />WA M <br />L & I Llo. # <br />G 115honallEmall <br />Address <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />Phone/F-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />HEAT SOURCE: <br />Existing Use of Building _ <br />Proposed Use of Building Gas Electric Omer <br />Building type: :� Single 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 (additions/ space provided on the beck): <br />NO <br />Have you started working without a permit? _YES��- <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project: _New _Addn _Alteration _Repair <br />Typo of Project: _Now _Addn _Alteration _Repair <br />Show Number(#) of fixtures <br />Show Number(S) of fixtures <br />A/C - air handling units <br />I Toilet <br />_ <br />Forced airs stems <br />Bathtub <br />— _ <br />Gas piping <br />Lavatory wash basin <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clolhes d er <br />Clothes washer <br />Rene hood <br />Water healer <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />Heat unto <br />BackRow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Bo <br />Bole <br />Drinkin Fountain <br />eralion <br />Floor drain <br />Woodslove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />1 hereby certify that I have read and examined this application and know the same to be Irue 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 slate or local taw regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to per rm the work for which application Is made and I comply with the Slate Contractors Lew 1a.27 RCW and 296200 WAC <br />GC ) <br />caner/Author) d Age Ignaturs Date (Revised 212e1t) <br />