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PERMIT APPLICATION <br />BUILDING/MECHANICALIPLUMBING/SIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857—www.everettwa.org 2 <br />se •rncoTCn ror1M a AM Tn A PM S <br />AFFLiCnr,vno nM.,,.,.�. <br />PERMIT # <br />SITE ADDRESS: <br />PROPERTY TAX R <br />— M <br />LEGAL for new construction: Short Platlsubdlvislon _Lot No. (attach copy of long legal description) <br />OWNER <br />PhonelE-mail <br />Address <br />CitylState/Zip <br />i <br />' it � � L & I LIc. # 0'1 k 1- I � 2-. } � U <br />), y <br />CONTRACTOR . � _ <br />II ,,' Phone/Email �OE� 2 2 2 <br />'dress J �� i(x., I �� ) h Sy / -t <br />TENANT BUSINESS NAME <br />CONTACT FOR <br />Y1 7l li CJY � -T19 P j�O/p <br />,PERMIT I' <br />Phone/E-mall T rG rr l� <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK /G <br />HEAT SOURCE: <br />Existing Use of Building <br />Electric Other <br />Gas _ <br />_ <br />Proposed Use of Building <br />Buildingtype: Family —Duplex _Townhouse _Muhl -Family �Commerciai <br />,_Single <br />Typeofproject: !-New _Addition _Remodel _Repair _T.I.—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 —NO <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _,Alteration_Repalr <br />Type of Project: _Now_Addn __Alteration __Repair <br />_New_Addn <br />Show Number (#i of fixtures <br />Show Number (#) of flrtures <br />A/C — air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Lavatory wash basin) <br />Gas piping <br />I Shower <br />Waler heater <br />Kitchen sink & dis osal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />Clothes washer <br />Clothes' at <br />Water heater <br />Range hood <br />Sink service/bar/mo /etc. <br />Exhaust fan <br />Backflow reventer <br />Heat um <br />Urinal <br />Unit heater <br />urmKmo Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />Grease trap <br />Woodstove <br />Roof drains <br />Ducting <br />Other <br />Medical Gas <br />SPRINKLER J 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 two and correct. All provisions of laws and ordinances governing <br />this type of work wall 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 state or local law regulating construction or the porionnance of construction. That I am authorized by the owner of this property <br />to perform the work for which application is made and I comply with the State Contractors Law 19.27 RCW and 29e.200 WAC <br />(Revised 2/201 f) <br />Owner/Authorized Allant Signature Data <br />IJ <br />