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( i <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAUPLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—www.evereriwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��'�N`"�I <br /> SITE ADDRESS: C /'M^ PROPERTY TAX N ERM�j _DD <br /> > . /fJ � <br /> LEGAL lor new construcllon: ShoA PlaUsubdivision Lol No._ (allech copy ol long legal description) <br /> OWNER PhonelE-meil — — <br /> Address 20 C, /� CitylStateRip � � <br /> CONTRACTOR — - L 8 I Lic.# G <br /> Address J � �� � l�Z(L Phone/Email ^ % O -� <br /> TENANT BUSINESS NA E CONTACT FOR PERMIT <br /> /� (///C 1 " % � <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICe oF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use oi Buiiding Gas Etectric_ Other <br /> Buiiding type: _Single Family _Duplex_Townhouse _Mulli-Family �Commercial <br /> Type of projecl: _New �Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Description oi Work(eddifional space provided on the back): <br /> Have you started working wllhout a pertnit? _YES �' NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo ol ProJect: _New_Addn _Alteratlon_Repair Type ol ProJect: _Naw_Addn _,Alteratlon_Rapalr <br /> Show Number(N)o/flxtures Show Number(N)o/Oxturea <br /> A/C—airhandlin units Toilet <br /> Forced�irs stems Bathtub <br /> Gas piping Lava" (wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink 8 dis osal <br /> Gasran e Dishwasher <br /> Clothes d er C'othes washer <br /> Ran e hood Water heater <br /> Exhausl fan � • Sink(servicelbarlmop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinkin Fountain <br /> Refri eration Floordrain <br /> Woodslove Grease trep <br /> Ducting Roof drains <br /> Olher Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other. <br /> Number of Heads Other: <br /> I hereby ceAify ihat I have read and examined Ihis appliwtion and know Ihe same lo be truo and cortect.Ail provisions ol laws end or0inances goveming <br /> this type ol work will ba complieA with whelher specifed herein or nol.The granting of a permit does not presume lo give aulhoriry to viotate or cancel <br /> the provision of nny other state or local law regulaling consiruclion or the pedormance of conslrudian.7het I am authorized by lhe owner ol this property <br /> to perform Iha work for which applic � made and 1 comply wilh Ihe Stato Con�raclors Lew 18.27 RCW and 296.200 WAC <br /> �/ <br /> Owner/AuthorizadA ontSlgna re D�fe (Revised7!lOff) <br />