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PERMIT APPUCATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRIN KLER/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 />APPI Ir.ATinNS APF ACCEPTED FROM R AM i0 4 PM <br />------- ------- <br />sl1EA,D—D.RRE� <br />�55 1� <br />PROPERTYTAX# <br />PERMIT# tl <br />LEGAL for new construction: Short PlaVsubdivision__ Lot No.__ (attach copy of long legal description) <br />OWNER bV-1 D A (.A e C!_ C Y <br />Phone/E-mail <br />Address b-gj-b ,! ' ` — <br />City/State/Zip e / - OG� <br />CONTRACTOR )�/OI a?-i IL <br />I Lic. #41 <br />c& <br />Address �' /L !�'/ ) ,.(/� �"7— PhonelEmaii ll <br />L �ZJ77lp,�%j <br />TENANT BUSINESS NAME <br />�l'L(/ �✓� �' 1U . -� / <br />CONTACT FOR PER—M1IT - 7.>�-el <br />PhonelE-mail 47S / -)L v G <br />BUILDING PERMIT APPLICATION <br />''— <br />CONTRACT PRICE OF WORD �fL!�F%'— <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. --iun _Sprinkler _Demolilion_Change of Use <br />Description of Work (additional space provided on the back): <br />i\Q-w A,-c vx)-Z�t-U'l <br />Have you started working without a permit? _YES _�NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project: ___New _Addn --Alteration __Repair <br />Show Number (#) of fixtures <br />Type of Project: ___Now __ Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />AIC- airhandlin units <br />Toilet <br />Forced airs stems <br />/ I Bathtub <br />Gas piping <br />/ Lavatory (wash basin) <br />Water healer <br />/ Shower <br />I I Gas fireplace <br />Kitchen sink & disposal <br />I Gas range <br />Dishwasher <br />Clothes dryer <br />I Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />j Sink (service/bar/mop/etc.) <br />Heat pump <br />Backflow preventer <br />Unit heater <br />I Urinal <br />Bailer <br />DrinkingFountain <br />Refrigeration <br />I Floor drain <br />Woodslove <br />Grease trap <br />Ducting <br />Roof drains <br />Other__ <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />I 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. I he granting of a permit does not presume to give authority to violate or cancel <br />the provision of any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to perfo the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC t/ <br />ow3p,Adth orized Agent Signature °Dot (Revised 212011) <br />