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< < <br /> F�ERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/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 /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM � � � <br /> SITE ADDRESS:/, ,� � PROPERTV TAX p Pf'qRM1T R _D � <br /> LEGAL for new conslruction: Short P'��Vsubdivision_ Lot No._ (allach copy of long legal descrtption) <br /> OWNER � - Z� � 2 PhonelE-me � ��J � — � <br /> Atldress � Cilyl5la�eO_Ip r VF YLF j f.✓� <br /> CONTRACTOR O(.VN�� L 8 I Lia# <br /> Address PhonelEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE•meil <br /> BUILDING PERMIT APPLICATION CONTRAcr PRlce oF WORK <br /> Existing Use of Building HEAT�OURCE: <br /> Proposed Use of Building Ges_ ElectAc_ olher <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type ot project: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolilion_Change of Use <br /> Descrip�ion ot Work(additional spece provided on the backJ: <br /> � I 1 �^ -/crr.�C� <br /> (' � t . <br /> CJ <br /> Have you atarted workfng wit t a pertnit7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of ProJeet: _New_Addn _Alteratlon_Repalr Tyae of ProJecl: _New_Addn _Akeration_.Rapelr <br /> Show Number(M)oI/lxtures Show Number(N)0//lxtures <br /> AIC-air handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas ipin Lavato wash basin) <br /> Water heater Shower <br /> Gas fiie lace Kitchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> Clothes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhausl fan Sink(service/bar/mo lelc.) <br /> Heat ump Backflow preventer <br /> Unit heater Urinai <br /> Boiler Drinkin Fountain <br /> Refri eration Floordrein <br /> Woodstove Grease trap <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby ceAify Ihal I havo read and examined ihis appiicalion and knaw Ihe same to be true and conect.All provisions of laws and ordinances goveming <br /> this type of work will be complied wilh whelher specified herein or not.7he granling oi a permit does not presume to give authority to violate or cancei <br /> the provision of any other stale or local lew regulaling construclion or the perlortnance ol consiruction.Thal I am authoAzed by the owner of this property <br /> to pertorm the work lor which applicalion is made and 1 compiy with Ihe Slate Contraclors Law 1827 RCW and 296.200 WAC <br /> � II <br /> �F�� n �1�.y—�„✓r� � - <br /> OwnerlAuthorized Agent Signatdre Date (Revised7/20f 1J <br />