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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 \,,vw.everettwa.org <br />1 -7--13 <br />STE <br />C /�i <br />PROPERTY TAX <br />PE MIT# !DYDDZESS <br />LEGAL for new consiructionShort PlaUsubdivision Lot No._ (attach copy of long legal description) <br />,OWNER / a <br />Phone/E-mail _C `Q <br />Address , I , _ ,l 1! City/State/Zip bl.-Ir, <br />APPLICANT: Owner- zOwneis Agent Voontractor _Contractor's Agent _Tenant (must prmrdo aloner of mnsem from tho mr%crto do woAm NO Spam) <br />S <br />CONTRACTOR ,n tp/�� <br />State Lic. # pfi City Bus. Lic. # <br />/ <br />Address <br />Phone/Email L - <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />r PhonelE-mail �' r <br />BUIL ING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK_ fie <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas___ Electric_ Other_ <br />Building type: _ Single Family _ Duplex _Townhouse—Mulli.Family VCommercial <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 />V h <� <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project: _Now _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Typo of Project: _Now _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C -air handling units <br />Toilet <br />Forced air systems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />I Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (servicelbar/mopletc.) <br />Heal pump <br />I BackRow pievenler <br />Unit heater <br />Urinal <br />Boller <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />W oodstove <br />I Grease trap <br />DDucting <br />Roof drains <br />Other <br />I Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other. <br />)m <br />I" <br />I hereby certify that I have read and examined this application and Arnow the same to be two and correct. All provisions of laws and ordinances governing this type of work will be complied <br />with whether specified herein or nol. The granting of a permit does not presume to give authority to violate or cancel the provision of any other state or local law regulating construction <br />That I am authorized by the owner of this property to perform the work for which application Is made and I comply with the Slate Contractors Law 18 27 ACW and 296 200A WAC. <br />&) 1 1 71-1 <br />Own tt <br />ulhorized Agent Signature ^ y Date (Revised 32013) <br />