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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES 6-10 —t( <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM Oc_, <br />SITE ADDRESS: <br />2!3! O ALlj CVL' {: -7 <br />PROPERTY TAX <br />OD I - r(3t oy5-ao <br />PERMIT# _ <br />E^ <br />LEGAL for new construction: Short Plal/subdivision Lot No._ (attach copy =^tong legal description) <br />OWNER pb S, <br />PhonelF.-mail Z.5 ZZB. <br />Address Ve��'—j <br />I/82Z, <br />City/State/Zip Z;:—E7 <br />CONTRACTOR <br />L & I Lic. # <br />Address Phone/Email <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />l.xvtsfi��sc�. <br />L3db G <br />PhonelE•mail 4X5 z(a lezz <br />BUILDING PERMIT APPLICATION <br />ICONTRACT PRICE OF WORK — <br />HEAT SOURCE: <br />Existing Use of Buuuing <br />Gas ✓ Electric ✓ Other_ <br />Proposed Use of Building <br />Building type: _Single Family _ Duplex `,/ Townhouse _Multi -Family _Commercial <br />Typeofproject: New —Addition _Remodel _Repair_T.I._Sign _Spdnkler_Demolilion_Change of Use <br />Description of Work (additional space provided on the back): <br />&���� <br />ZINO /�e lCX— <br />Have you started working without a permit? _YES _ <br />MECHANICAL PERMIT APPLICATION <br />PLUMBIN4 PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Typo of Project: _Now _Addn _Alteration _Repair <br />Show Number(#) olfrxtures <br />ShorvN ber(#) of fixtures <br />A/C it handling units <br />Toilet <br />Fgfcedairs stems <br />Bathtub <br />Lavatory (wash basin) <br />as piping <br />2 <br />Water healer <br />Shower <br />Gas fireplace <br />2 <br />Kitchen sink 8 dispcsal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (servicelbar/mop/etc.) <br />Heat pump <br />Backllow preventer <br />Unit heater <br />1 <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 I SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby certity that I have read and examined this application and know the same lobe true 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 stale 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 for whl h applicalon is made and 1 comply with the Stale Contractors Law 18.27 RCW and 296.200 WAC <br />Ownor/Authorized Agent Signature Date (Revised 2Q011) 1 <br />