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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 />I—S--/`Z <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 1-1,11 <br />SITE ADDRESS: <br />to OZ t k <br />PROPERTY TAX# <br />PE MIT# _O ` <br />U <br />LEGAL for new construction: Short Plal/subdivision Lot No._ (attach copy of tong legal description) <br />OWNER-5ke1: -�TGLI L <br />Phone/E-mail <br />Address ZIO S V L <br />City/Stale/Zip A A5-7(05 <br />CONTRACTOR .rt 0m S ' <br />L & I Lic. # 'Prc.v\, 5 c L a 5 3 (- <br />Address t; Wq c LA ltZDto Phone/Email 951 14Y- a b <br />TENANT BUSINESS NAME <br />L <br />CONTACT FOR PERMIT <br />PAIEv qAi <br />Phone/E-mail 17 bi 7,1101- <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building <br />HEAT SOURCE: <br />Proposed Use of Building <br />Gas_ Electric_ Other_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi -Family XCommercial <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 />��Ll NtIwNT turf-rueTt Faa-t"lru,rl <br />- l t 1-lleS o)\ <br />A t;aks ��- ce>� "3 <br />Have you started working without a permit? _YES ZNO urio t n --tfL f-x n I0-&-J <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project: _New_Addn _Altoratior _Repair <br />Show Number (#) of fixtures <br />Type of Project: _New_Addn —Alteration —Repair <br />Show Number (#) of fixtures <br />A/C - air handling un is <br />Toilet <br />Forced air systems <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/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 />Woodsleve <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 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 stale or local law regulating construction or the performance of construction. That i am authorized by the owner of this property <br />to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />Owner/— Agent Signature Authorized Dale (Revised 2/I071) J_ <br />