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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 - =Av.everettwa org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM 6 _ 3 - /3 <br />SITE'ES,PROPERTY <br />C9po s tic_ r� 14d� <br />TAX p <br />co`Iu3OV000rr0b <br />PERMIT e <br />ml 6-0 <br />1' <br />LEGAL for new construction: Short PlaUsubdivisior PA tr2VrC Kt i�IEIGXiS Lot No. q (attach copy of long legal description) <br />OWNER -:TtD%kV,% Lkf E. <br />Phone E-mail Lf Zs -•1, 2 <br />Address /p li p s p P: h r F rZ R V <br />Citylstatelzip j_q r 2c- rf q% r) IZ2 03 <br />CONTRACTOR P1 L-4 GQ'h NTG_ frll t- <br />L 81 Lic.: I_t-Cr-7_ 4 e- (D <br />Address Sx G_ Lo9te, t.T L,pM N- 5 g0c Z Phone/Email Z�_7 (p-,3 D <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />rS <br />S1 D) 1-loLbr <br />Phone!E-mail 0"L% <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK iw <br />V <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building GasEled;i— Other_ <br />Building type: _ Single Family _Duplex _Townhouse _ Multi -Family —Commercial <br />Type of project: _New —Addition — Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />Description of Work (additional space provided on the back): <br />Have you started working without a permit? _YES ,_NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _Now_Addn _Alteration�LRepair <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (p) of fixtures <br />Show Number (p) of Fixtures <br />A/C - air handlinq units <br />Toilet <br />_ <br />Forced air systems <br />___ <br />Bathtub <br />I Gas piping <br />Lavatory (wash basin) <br />_ _ <br />I Water heater <br />I Shower <br />_ <br />Gas fireplace <br />__ <br />I Kitchen sink & disposal <br />Gas range <br />__ <br />Dishwasher <br />Clothes dryer <br />I Clothes washer <br />_ <br />I Range hood <br />__ <br />Water heater - <br />_ <br />I Exhaust fan <br />I Sink (service/bar/mop/etc.) <br />_ <br />Heat pump <br />Backflow preventer <br />_ <br />I Unit heater <br />I Urinal <br />Drinking Fountain <br />_ <br />I <br />Boiler <br />_ <br />Refrigeration <br />Floor drain _ <br />Woodstove <br />Grease trao <br />_ <br />Ducting <br />Roof drains <br />I <br />Other <br />I <br />Medical Gas <br />_ <br />SPRINKLER ( SUPPRESSION SYSTEM <br />I <br />Other <br />Number of Heads <br />- <br />I hereby certify that I have read and examined this application and know the same to be true and coned. All provisions of laws and ordinances governing <br />this type of work will be complied with whether specified herein or not. The 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 perform the work for which application is made and I comply with the Stale Contractors Law 18.27 RCW and 296.200 WAC <br />O r/Authorized Agent Sig afore Date (Revised 72R070J <br />