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U <br />PERMIT APPLICATION <br />BUILD ING/MECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.evereltwa.Org <br />it ATMNS naF er:r:FPTED FROM 8 AM TO PM <br />SITE ADDRE <br />�n^1 ` V PROPERTY TAX 9 PERM <br />SS$: 2 L, 7 I I <br />�� 1 w C LEGAL- for new construction: Short PlaVsu6division_ __ Lot No.__ (attach copy of long legal description) <br />OWNER ) ik l (' Phone/E-mail L <br />Address Pr^(� G� ti-�. City/Stale/Zip <br />L&ILic.# <br />CONTRACTOR AA <br />Address �� rV �y r'O n{i Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERM(ITj J <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />HEAT SO RCE: <br />Existing Use of Building ( <br />_, t r�----- , <br />Gas_ �! ctnc Other_ _ <br />Proposed Use of Building 14 ram`, / <br />Building type: _Single Family _Duplex Townhouse _Multi _Commercia t <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): / o h I' t' /i "w S -PN Cc, <br />1 C Iti <br />Have you started working without a permit?' _YES _NO <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Typo of Project: _New _Addn _Alteration _-Repair Type of Projuce —New _Addn _Alteration _Repair <br />Show Number (it) of fixtures <br />Show Number (#) of fixtures - Toilet <br />A/C - air handling units Bathtub <br />Forced air systems Lavatory (wash basin) <br />Gas iping Shower <br />Water heater Kitchen sink & disposal <br />Gas fireplace Dishwasher <br />Gas range Clothes washer <br />Clothes dryer Water heater <br />Range hood Sint. (service/bar/mop/etc.) <br />Exhaust fan <br />Heat pump Backflow preventer <br />Urinal <br />_ Unit heater — Drinking Fountain <br />Boiler Floor drain <br />Refrigeration Grease trap <br />Woodstove Roof drains <br />Ducting <br />Medical Gas <br />Other <br />SPRINKLER I SUPPRESSION SYSTEM Other: <br />Number of Heads 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 he omplled with ether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel <br />the provision of any olh r slate or to aw regulating construction or the pedormence of construction. That I am authorized by the owner of this property <br />to perform the work far ch appli is made and I comply with the Stale Conlractors� �� RCW and 296.200 WAC <br />(Revised 2/2011) <br />MCNT <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 he omplled with ether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel <br />the provision of any olh r slate or to aw regulating construction or the pedormence of construction. That I am authorized by the owner of this property <br />to perform the work far ch appli is made and I comply with the Stale Conlractors� �� RCW and 296.200 WAC <br />(Revised 2/2011) <br />MCNT <br />