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PERMIT APPLICATION <br />BUILDING/MECHANICAUPLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES 711y /11 <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 - FAX 4?5-257-8857 - www.everettwa.org <br />cool rcennNv ARF ACCFPTFD FROM 8 AM TO 4 PM <br />SITE ADDRESS: <br />PROPERTY TAX <br />P ITilu a ,lam <br />LEGAL for new consttrr—u-ction. Shorl PlaVsubdivlslun Lvt No._ (attach copy of long legal description) <br />OWNER <br />- V �' <br />Phone/E-mail <br />Address <br />City/State/Zip <br />CONTRACTOR <br />L 8 I Lic. N <br />Address Phone/Email <br />TENANT BUSINESS NAME <br />C[,rNC <br />CONTACT FO PERTM, IT <br />I,�t <br />Phone/E mall /`-,•'l�G�✓K� <br />BUILDING PERMITAPPLICATION <br />ICONTRACT PRICE OF WORK <br />/ <br />Existing Use of Building J A h6 7-E P- )P <br />HEAT SOURCE: <br />Proposed Use of Building J9ri rLK) •J (, `PT Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi -Family —_ Commercial <br />Type of project: _ New _ Addition _ Remodel _ Repair _ T.I. _ Sign __Sprinkler _Demolition_Chanje of Use <br />Description of Work (additional space provided on the back): <br />T�EI^^�LISN �3(;1�•D,rJ6-Q2>rp�2TldrJ f�K- )�j}2r<r�C� C-o1' <br />Have you started working without a permit? _YES X NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number(s) of fixtures <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (N) of fixtures <br />NC — air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin <br />Water healer <br />Shower <br />Kitchen sink 8 disposal <br />Dishwasher <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink service/bar/mop/etc.) <br />Heat pump <br />Backflow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Dicting <br />Roof drams <br />Other _ <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other. <br />Number of Heads <br />Other. <br />I hereby certify that I have read and examined this application and know the some 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 stele or local law regulating construction or the performance of constructlon. Thst I am authorized by the owner of this property <br />to perform the wnrk for which application made and I comply wi r the Slate Contractors Law 19 27 RCW and 290 200 WAC <br />(Revised ?F1011J <br />nerlAulhorized Agent Slgnsture Cale <br />