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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 />7 `lS-i <br />SITE ADDRESS: <br />PROPE tAX le <br />RMI <br />P T # O — D <br />LEGAL for new construction. Short PlaUsubdivislon Lot No. (altach copy of long legal description) <br />OWNER S U <br />PhonelE-mall <br />Address <br />U <br />Ciwslatetzip — <br />O <br />APPLICANT: —Owner _Owner's Agent — enbaclor Contractor's Agent _Tenant lmuoi era.ao uiccer cl wn:enl vein mo o»aer io da w�a n ina spaze) <br />CONTRACTOR (-� Trite T— <br />Slate Lic. # City Bus. Lic. # <br />Address <br />Phone/Email <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />IF'hone/E-nnail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas _ _ Elecidq Other_ <br />Building type T_ 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 (additional spaceprovidedon the back): <br />nSi'a1` �vJ ����� �� G �u..r v�c,.t✓ c� <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project: Now _Addn _Alteration _Repair <br />Show Number (#) or fixtures <br />Typo of Project: _New _Addn _Alteration _Repair <br />Show Number (a) or tortures <br />A/C — air handling units <br />Toilet — <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink 6 disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />_ <br />Sink (service/bar/mop/etc ) <br />Heat pump <br />Back (low preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodslove <br />Grease trap <br />Ducting <br />Roof drains <br />Other _ <br />Medical Gas <br />SPRINKLER <br />I SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />Other: <br />I hereby ccally that i have read and examined this appicaton and know Ina same to be INe and correct AN provisions of laws and ordinances governing this type of work wA be compied <br />with whether specified herein or not. The granting of a pennd does not presume to give oulhouly to vro atc or cancel the provisiM of any other state or local low regulating constructor, <br />That 1 am authomed by the owner of this property to perform the work lot which applicator; is made and I compN with the State Conlratters Law 18 27 RC W and 298 200A WAC. <br />Owner/Authorized Agent Signature DaIa (Revised Yl0f8) <br />