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� .�► <br /> . <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-6610—FAX 425-257-8857—www•everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM � '� �3 `�I <br /> SITEADDRESS: �? �s lpA�' �,1AI,f' 1'' �I PROPERTYTAXN PERMITi <br /> lJI�+•( I�r�17V V <br /> LEGAL for new canslruction: Short PlaVsubdivision Lot No._ (attach copy ot long legal desuiption) <br /> OWNER �bl/� PhonelE-mall <br /> Address CitylSlate/Zip <br /> CONTRACTOR T� N�IT L&I Lia# <br /> Address PhonelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> GAF`� AY ���'Iti� PhonelE-mail �- d` J 2 �Or � O ,(•�m <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Ges_ Eiecttic Other_ <br /> Buiiding type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type ot project: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Descfiption of Work(atldifional space provided on fhe beck): � �� ��� <br /> Have you slarted worktng without a pemilt7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJeel: _Now_Addn _Alleratlon_Repair Type ol Project: _New_Addn _Alteratlon_Rap�lr <br /> Show Num6er(N)ol Cxturos Show Number(M)o!RMures <br /> A/C—airhandlin units � Toilet <br /> Forced air s slems Bathlub <br /> Gas ipin Lavato (wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink 8 dis osal <br /> Gasran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Waler heater <br /> Exhaust(an Sink(servicelbar/mop/etc.) <br /> Heal pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinkin Founlain <br /> Refrigeralion Floor drain <br /> Woodslove Grease lra <br /> Duclin Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM other: <br /> NumberofHeads Olher: <br /> I hereby certiry Ihat I have read and ezamined this application end know Ihe same to be Irue and conect.All provisions of laws and ordinances goveming <br /> this lype of work will be complied wilh whelher specified herein ar not.The granling ol a permil does r.ot presume to give authority lo violate or wncel <br /> the provislon of any other state or local law regulaling consiruction or tho pertormance ol conslruclion.That 1 am authorized 6y the owner ol lhis propeAy <br /> to p�rm ihe work lor wl ich application is mada and I comply with Ihe:�ale Conlraclors Law 18.27 RCW and 296.200 WAC ( <br /> nerlAutharizedAgo Ignaturo Date f I (RevisedT/2071) �� <br />