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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 V-13 -'If <br />SITE ADDRESS: 0 5.,-! �Y I`Ef l .N," <br />/, r7Y� <br />PROPE f �V v n r Z <br />PERM' � v_ DO S <br />LEGAL for new construction: Short Plattssubddi[vision Lot No._ (attach copy of long legal description) <br />OWNER EkL5rW FWILNI <br />Phone/E-mail <br />r/UC <br />Address ZSNr vorot.✓ r� � <br />t A pp� <br />City/SIale/Zip 9��/ IV# iO0l0 <br />CONTRACTOR ?J01VA4 $ <br />L 8 I Lic. # sceirrw13 _ <br />ti <br />�,f' <br />C -/�"7'• ,.Q <br />Address %Zf/ VIXIAU 0, /`"• Sfl�i� 010� Phone/Email ?/{ 2.FZ- #76V <br />TENANT BUSINESS NA,ME <br />miC/CD µ �/ <br />CONTACT FOR PERMIT S.Of Zit* 1 rd11A1 <br />Phone/E-mail ah)'22(Z'0%iris <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building 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_Change of Use <br />Description of Work (additional space provided on the back): <br />Aww1s/7 f wf L )c1.37fAlf swif%F W reeNP1111r✓41�0 J✓� �I ��s. <br />/Irjowr "phyMY r1 1'effM3 ✓171V 11101610" PPL ,ffKH6)i p/,#f, /ZFrwr, U`0 t/#- <br />Have you started working without permit? _YES _NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <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 & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (service/badmopletc.) <br />Heat pump <br />Backfiow 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 / 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 same to be true and correct. All provisions of laws and ordinances governing <br />this type of work will 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 q�an herhlate or local law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to perform th r r hich application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />Date (Revised ZQ011) <br />lb <br />