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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBINGISIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Evereti, WA 98201 -425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM "� `� 3 <br /> SITEADDRESS: � PROPER7YTAXN P M�T�O <br /> � S o-�� - � <br /> LEGAL for new constmclion: Shod PlaUsubdivi - Lol No._ (atlach copy of long IeBal description) <br /> OWNER PhonelE-mail <br /> ?.ddress CitylSlate/Zip <br /> CONTRACTOR L&I Lic.# <br /> Atldress PhonelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT��'e/_ �/� �_ <br /> !/�L'� �tY �� /� �� PhonelE-mail — ,S— � <br /> BUILDING PERMIT APPLICA ON coNrRAC7 PRlce oF WORK �� ' <br /> Existing Use of Ouilding HEAT SOURCE: <br /> Proposed Use of Building Gas electric Oiher_ <br /> 8uilding type: _Single Family _�cplex_Townhouse _MWIi-Famity _Commercial <br /> Type ot project: _New _Addition _Remodel _Repair_T.I._Sign_Sprinklcr_Demoldion_Change of Use <br /> Description of Wotk(adddional spece pmvided on f�e back): ' �. <br /> ,�� GfP�? u�l.�� <br /> Have you slarted working without a pertnllT _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypoofProJect: _Now_Addn _Alteretlon_Ropalr 7ypeofPro�ect: _Now_Addn _Alteratlon_Repalr <br /> Show Number(p)ol/ixtures Show Number(A)o/fixturns <br /> A/C—air handling unils Toilet <br /> Forced air systems Balhtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fimplace Kitchen sink&dis osal <br /> Gas range Uishwasher <br /> Clolhes dryer Clothes washer <br /> Range hood Water heater <br /> Exhausl(an Sink(service/bar/mop/etc.) <br /> Neal pump BackBuw preventer <br /> Unit heater � Urinal <br /> Boiler Drinkino Feuntain <br /> Refrigeration Floor drain <br /> Woodstove Grease trzp <br /> Ductin Roof drins <br /> � Other_ Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> � Kumber ot Heads Other: <br /> I hereF�ceAily Ihat I have read and eKamined ihis appliwlion and know Ihe same to be irue and correcl.All provisions ot laws and ordinances goveming <br /> this type ol wurk will b^complied wilh whether specifed herein or noL Tho granting ot a pertnil does nol presume lo give authority to violate or cancel <br /> the provision of any other stele or local law regulating consWction or the peAormance ol conslmction.That I am authotlzed by ihe awner of this propeAy <br /> to pedortn the woik for which application ia made and I comply with the State Contractors Law 18.27 RCW anA 2B6200 WAC <br /> OwnerlAuthodzed Agont Sfgnaturo Dale (Revised 2/2077J �'� <br />