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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 - www.e.verettw`a.org <br />ACCEPTED FROM R AM Tr) d PM /V - :? S' /Z <br />PERMIT# <br />SITE 4DDRESS: `aPAc-k- ��- PROPERTY TAX <br />UZ <br />Jg0q- Sc EJ�K�TT MALk_ W1 <br />LEGAL for new construction: Short Plat' subdivision Lot No._ (attach copy of long legal deescri-ption) <br />l��J <br />S PhonelE-mail <br />OWNER T�ya �-((���, <br />Address Moo Qt)tb Lk "Ypp City/State/Zip' (j�lr, �-- `, 1V1 <br />1T 4�(O <br />I Lic. # _ <br />CONTRACTOR -V L 8,1 <br />Phone/Email <br />Address <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT.�b <br />lei-L1'1��1i <br />�LAR6'�eS �e <br />I, �'LSS J�C�t9`y(LG-�� <br />PhonelE-m it �U - <br />arL <br />DU <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />HEATSOURCE: JC51, t� <br />Existing Use of Building <br />Proposed Use of Building Gas_ Electric_ Other_ <br />Building type: Single Family _ Duplex _Townhouse _ Multi -Family _Commercial <br />_ <br />Type of project: _ New _ Addition _ Remodel _ Repair _ T.I. Y, 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 �-4 NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: <br />_Alteration _Ropair <br />Typo of Project: _New <br />_Addn ,_Alteration _Repair <br />_Now_Addn <br />Show <br />Number (#) of fixtures <br />show <br />Number (#) of fixtures <br />A/C - air handling units <br />Toilet <br />Bathtub <br />Forced air systems <br />Lavatory(wash basin) <br />Gas piping <br />Shower <br />Kitchen sink & disposal <br />Water heater <br />Gas fireplace <br />Dishwasher <br />Gas range <br />Clothes washer <br />Clothes dryer <br />Water heater <br />Range hood <br />Sink (service/bar/mopletc.) <br />Exhaust fan <br />BaCkfiow preventer <br />Heat pump <br />Urinal <br />Unit heater <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />_ <br />Grease trap <br />Woodstove <br />Roof drains <br />Ducting <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />I Other: <br />I hereby certify that I have read and examined this application and know the same to be true and correct. 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 pro Ision of any of r state or local law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to p the work I hich application is made and I cornply wi the St a Contactors Law 18.27 RCW and 296.207 WAC <br />(Revised 2/2011) <br />OwnerlAuthorizedA nt Signature to <br />;S.0 <br />