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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 ICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />APP <br />SITE ADDRESS: <br />PROP�Im TARN <br />Mlv <br />5-a <br />co <br />LEGAL for new construction: Short Plat/subdivlslon —Lot No. (attach copy of" legal deeaiptIon) <br />OWNER Q t� �� Phone/E-mail <br />Address 3 City/Stete/ZJp Q✓ WIT <br />CONTRACTOR ! p n L�II Uc.. N 4- <br />hone/Email <br />`& <br />Address ( T 7 �i C (/v (/" <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK lox- <br />` <br />Existing Use of Building <br />HEATSOURCE: <br />Proposed Use of Building Gmy Elecldc other <br />Building type: _Duplex_Townhouse _Multi -Family _Commercial . <br />,KSingleFamily <br />Type of project: —New ,Addition —Remodel _X Repair_ T.I. _Sign ___Sprinkler _DemolRionLL_/ Chun se <br />Description of Work (additional space providedon the back) : _ % 914t) ��� � PA JA(— .(%.}fAIt <br />- +—(LY�1QV��,tt — (J✓yf ll—Elec.- (��,5�r 4-761K <br />Have you started working without a permit? YES _NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typeof Project: _New_Addn _Alteration _—Repair <br />Type of Project: —New _Arkin _Alteration _Rapelr <br />Show Number of fixtures <br />Show Number of fixtunes <br />A/C — airhandlin units <br />Toilet <br />Forced airs stems <br />Bathtub <br />! <br />Gas piping <br />ate Lavatory wash basin <br />! <br />Water heater <br />U Shower <br />! <br />Gas fireplace <br />0 Kitchen sink 8 dis osal <br />! <br />Gas range <br />' Dishwasher <br />■ <br />Clothes dryer <br />Clothes washer •R <br />Range hood <br />Water heater ate <br />Exhaustfan <br />Sink(service lbar/mo /etc. <br />_ <br />■ Heat um <br />Badcflow reveller <br />■ Unit heater <br />Urinal <br />■ Boiler <br />Drinkina Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />n<_ <br />Grease trap <br />Ductin <br />! <br />Roof drains <br />other u l wof Su.h <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />"� <br />Other: <br />Number ear's <br />Other: <br />Ja <br />I hereby certify that I havp, n e examined this application and know the same to be true and correct. All provisions of laws and ordinances governing <br />this type of ill be mH�� Whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel <br />the provisi o ny o er stet I law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />nano t work r plication Is made and I comply with Ille §tale Contractors Law 18.27 RCW and 298.200 WAG <br />(Revised Z02011) <br />