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PERMIT APPLICATION <br />BUILDING!MECHANICAL/PLUMB!NG/SIGN/SPRINKLER EMOLITIO <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.org` t/ <br />c AMC er!`GOTFrI FRr1M R AM TO 4 PM <br />PERMI <br />SITE ADDRESS: PROPERTY TAX# Tt/Oj —DO <br />13 0 GTo�-F3 - <br />LEGAL lot P^w construction: Shod Flatisubdivision Lot No. (attach copy of long legal description) <br />OWNERC, L Fhone/E-mail YZ5 218 / Z2. <br />-rY1!' <br />-0 <br />�$0 <br />Address �o30 C RALt Q AlIE ` City/Slate/Zip cVEi;T7'7- oli: 9S7-4/ <br />CONTRACTORC f Pn1<P 1J GUH!-R'r IWe- L & I Lic. # <br />Address zO30 uFZAN Phone/Email AfZ.$ ZIS /$ZZ <br />TENANT BUSINESS NAME CONTACT FOR PERMIT aoB G�tRI ST£NS" <br />Phone/E-mail v'{'Z5 218 tozz. <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />HEAT SOURCE: <br />Existing Use of Building <br />Gas_ Electric_ Other_ <br />Proposed Use of Building <br />Building type: Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of project: _ New _ Addition _ Remodel _ Repair _T.I. _ Sign _Sprinkler Demoliti/o�n Change of Use <br />Description of Work (additional space provided on the back): <br />i I C_ (i �� � �Oa✓ <br />Have you started working without a permit? __YES _NO <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Typo of Project: _Addn _Alteration _Repair Type of Project: _Now _Addn _Alteration _Repair <br />_New <br />Show Number (#) of fixtures Show Number (N) of fixtures <br />NC - air handling units Toilet <br />Fcrced air systems Bathtub <br />Lavatory (wash basin) <br />I Gas piping <br />Shower <br />Water heater <br />Kitchen sink 8 disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />Clothes washer <br />Clothes dryer <br />Water healer <br />Range hood <br />Sink (service/barlmop/etc.) <br />Exhaust fan <br />Backflow preventer <br />Heat pump <br />Urinal <br />Unit heater <br />Boiler <br />Drinking Fountain <br />Floor drain <br />Refrigeration <br />Grease trap <br />Woodstove <br />Roof drains <br />Ducting <br />Other _ <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />I Other: <br />Number of Haads <br />I Other: <br />I hereby cei, y 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 lype 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 />to perform the work lot which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />Owner/Aulhorized A, ent Slgnaturo Date (Revised 2l1017) <br />