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PERMIT APPLICATION <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 />Boot ICATOt ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS:I <br />PROPERTY TAX <br />LEGAL for new construction: Short Plat/subdivision <br />Lot Ire_ (attach copy of long legal description)) <br />PhonelE-mail <br />OWNER —�'�'� <br />Address ' % i <br />City/Stale/Zip' - <br />r <br />APPLICANT: —Owner Owners Agent Contractor _ Contractor's Agent Tenant(mmlpmvldeakmrefcomenllrommeovmertedoworxinmespace) <br />CONTRACTOR <br />L & I Lic. # COE Bus. Lic. # <br />Address i <br />Phone/Email,-rr>i <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />awe <br />GI 0 I <br />PhonelE-mall" - <br />CONTRACT PRICE OF WORK <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building <br />HEAT SOURCE: <br />Proposed Use of Building <br />Cas___ Electric_ Other_ <br />_a <br />Building type: _ Single Family —Duplex _Townhouse _ <br />Muiti-Family Commercial <br />Type ofproject: —New _Addition —Remodel __Repair <br />_T.I. __ Sign _Sprinkler _Deniolition_Change of Use <br />DESCRIPTION OF WORK (additional space provided an the back): <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _Now_Addn —Alteration _Repair <br />Type of Project: _New_Addn --Alteration --Repair <br />Show Number 0 of thaures <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 healer <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />j <br />Gas ran a <br />Dishwasher <br />Clothes dryer <br />Clotheswasher <br />Range hood <br />Water healer <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />Heal pump <br />Backflow preventer <br />Unit healer <br />==�Drinlkinq <br />Urinal <br />Boiler <br />Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />I <br />Ducling <br />Roof drains _ <br />Other_ <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />I Other: <br />I hereby cedM that I have read and examined this application and know the same lobe two and conect. All provisions of lava and ordinances governing this type of work will be wmpmd <br />with whether specified herein or not. The granting of a peril does not presume to ghm sahomy to violate or cancel the provision of any other stale or local law regulating construction <br />That I am authorized by the owner of this propedy to perform the work for hi:happlication Is made and I complywth the State Contractors Law 18.27 RCW and 208.200AWAC. <br />(Revised li/20f1) <br />Owner/Authorized Agent Signature -�. Dale <br />