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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PL.UMBING;SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org` / <br />CCEPTED FROM 8 AM TO 4 PM <br />APPLICATIONS ARE A <br />SITE ADDRESS: _ <br />PROPERTYTAX# <br />P �1I7O <br />if <br />LEGAL for new construction: Shoo Plat/subdivision Lot No._ (attach copy of long legal description) <br />PhonelE-mad L C yks 10 <br />OWNERPk I I r� <br />Address S,2SNf City/State/Zip <br />APPLICANT: -Owner AgentContractor _ Contractor's Agent _ Tenant lmast prodrdea kne:mma.em hcm the ow,er to do..oa lame space) <br />_Owner's <br />r ttm L & I Lic. # COE Bus. Lic. # <br />CONTRACTOR <br />Phone/Email <br />Address - <br />CONTACT FOR PERMIT <br />TENANT BUSINESS NAME <br />Phone/E mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK_ <br />�{ <br />HEAT SOURCE: `. <br />Existing Use of Building � � <br />!_ �� -� <br />1.� Gas- Electric_ Other__ <br />Proposed Use of Building�t.�,a� w„l <br />Building type: Single Family _ Duplex _Townhouse —Multi-Family _Commercial <br />Type of project: _New _ Addition ✓Remodel _ Repair T.I. _ Sin Sprinkler _Demolition_ Change of Use <br />DESCRIPTIONOF F,WI ORI�(ar�tlilional jSp�ace Provided on the back)` 7S� <br />�r-l-lab_fitm06�}C6i�=��exf.S•'F�r` }�5'i�c-d ,!`e�,dc,le ��e-txtl�v-��i ✓lIIrct-T•"c.c. <br />iV J fJYII <br />ok p J` .} no lr� fv1 r <br />r Id <br />MECHANICAL PERMIT APPLICA 10 LUM13ING PERMIT APPLI ATION <br />Type of Project: <br />_Adds Alteration _Repair <br />Type of Project: _New <br />_Addn _Alteration _Rapair <br />_New <br />Snow <br />Number la) of fixtures <br />Show <br />Number (a) or 1,Aures <br />A/C -air handling units <br />Forced air systems <br />ht <br />Bathtub <br />Bat <br />(wash basin) <br />Gas pipingLavatory <br />Shower <br />'Hater heater <br />Kitchen sink &disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />Clothes washer <br />Clothes dryer <br />_'I <br />Water heater <br />Range hood <br />Sink (service/bar/mop/etc.) <br />Exhaust fan <br />I Backflow preventer <br />I feet pump <br />Unit heater <br />Urinal <br />I Drinking Fountain <br />Boiler <br />Floor drain <br />Refrigeration <br />Grease trap <br />Wood stove <br />Wood <br />Roof drains <br />Ducting <br />Medical Gas <br />Other <br />SPRINKLER / SUPPRESSION SYSTEM <br />other: <br />Number of Heads <br />Other: <br />I hereby cents that I have read and examined this applratlen and know the soma lobe bue and correct. AM provisions of lam and ordinances governing this type of work will be complied <br />with whether speafed herein or not. The granting of a permit does not presume to giva authority to Notate or cancel me prevision of any ether stale or local law reguialing construction <br />That i am authorized by the owner of this propertyto perform the work for which appmatien Is made and I comply win the Slate Contractors Lew 76.27 RCW and 296.200A WAC. <br />Ar/4Authoriz, attire Date (Revised 620121 <br />