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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-9810 —FAX 425-257-8857 — www.everettwa.org <br />n, !"T!ONS ARE ACCFPTFn FROM R AM TO 4 PM 3 "$ — 12 <br />RM or <br />SS PROPERTY TAX# PM <br />_ I <br />S`Tr 1 U� <br />LEGAL for new conpstruction: Short Plat/slubdivision Lot No._ (attach copy of long legal description) <br />OWNER <br />�'j ��l <br />Phone/E-mai S 6 <br />c'\ <br />Address tq Od ttZ SJ 1S��U <br />Ciry/Slate/tip — W <br />CONTRACTOR 1 , I -e f/ <br />L 8 I Lic. # <br />Address Phone/Email <br />TENANT BUSINESS NAMF� _ <br />CONTACT FOR PERMI `-4Z� z Z O '- ct D /, 1 <br />`f <br />I <br />5 W(-C I n S h�'� TR oCA ` � <br />I <br />Phone/E-mail ( I <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK � D 00 <br />HEAT SOURCE: <br />Existing Use of Building <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 _Demolition_Change of Use <br />Description of ork (additional space provided on the back) : <br />0 6- <br />Have you started working without a permit? _YES _NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project: _New _Addn _Alteration _Repair <br />Type of project: _New _Addn _Alteration _Repair <br />Show Number(II) of fixtures <br />Show Nurrrbw (0) of Nxfures <br />I <br />A/C -air handlingunits <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory wash basin) <br />I <br />Water healer <br />Shower <br />Gas fire lace <br />Kitchen sink 8 disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />I Water heater <br />Exhaust far, <br />Sink (service bar/mo /etc.) <br />Heat pump <br />I 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 / SUPPRESSION SYSTEM <br />I 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 [rue 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 provision of any other slate or local law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />1p.pgail n he work for which application is made and t comply with the State Contractors Law 18.27 RCW and 296,200 WAC <br />(Revised 2/2011) 1I <br />L <br />