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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLU%4BING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETr PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br />APPI [CATIONS ARE ACCEPTED FROM 8 AM TO 4 PM II /& %—L <br />_ <br />SITE ADDRESS: Y 7 <br />PROPERTY TAX h <br />V <br />LEGAL for new construclion. Short Plausubr ivision Jot No._ (attach copy of long legal descnption) <br />OWNER 1( <br />Phone/E-mail <br />Address <br />City/Stale/Zip <br />APPLICANT:__ OAner _Owners Agent Contractor Contractor's Agent Tenant fmustpmvdoaknorotcomemrtommemmertod..o ,nmespaocI <br />CONTRACTOR <br />L & I Lic. #pp W L—L COE Bus. Lic. # <br />Address 2— �' �o Phone/Email C"O <br />TENANT BUSINESS NAME <br />Pa S6 -S e- ��C, <br />CONTACT FOR PERMIT <br />Cn,S, e 01Gy i <br />7 <br />Phone/E-mail t <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK G <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use Of Building Gas__ Electric_ Other_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial. <br />Type of project: New _Addition Remodel _ Repair T.I. _ Sign Sprinkler Demclition_Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): <br />(37) ire 2- <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn —Alteration _Repair <br />Show Number (#) of fixtures <br />Type of Project: _New_Addn —Alteration _Repair <br />Show Number 00 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 />Clothes washer <br />Range hood <br />Water healer <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />Heat pump <br />Backflow, preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER <br />I SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby ceddy that I have read and examined this application and knew the same to be We and coned. At provisions of lam and ordinances governing this type of work will be complied <br />wah whether specified retain or not. The Itrandng of a permit does not presume to give authority to violab or cancel the prevision 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 State Contractors Lew 10.27 RC W and 296.200A WAC. <br />q,12 <br />Owneier/Authorized Agent Signature Date <br />I <br />(Revised 6/2012) <br />t).Co.n <br />CID" <br />Iry <br />