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• <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/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 />SITE ADDRESS' <br />S <br />PROPERTY TAX# <br />PEH ATa <br />5-on <br />LEGAL for new construction' ShortPlaUsubdivision Lot No, (attach copy of long legal description) <br />OWNER <br />one/E-mail <br />-'ddress <br />0ly/Slate/2ip <br />APPLICANT: Owner ONrefs.,gcnl C<ConPaclor _ Conlralor's Agent _Tenanl(musl�poreealenercr mnsmlWmea v+rn loaa..om nma:card <br />CONTRACTOR r tia`(7Vi_ �y Z_✓ Stale Lic. # Bus Uc # _ <br />a ddress 3 �� PhonelEmai' <br />TENANT BUSINE$Ci NAME <br />C07yssFA CT FO�PERN)ITyy <br />Phcr'cIF✓:Id 'A� _ F'S �� <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />HEAT SOURCE. <br />Existing Use of Budding _ <br />F <br />/art <br />Gas,_ Electric_ Other_ <br />V e' <br />Proposed Use of Building <br />Building type Single Family —:-6uplex _Townhouse _ Multi -Family _Commercial <br />_ <br />Type of project _ New _ Addition __ Remodel Repair — T.I. _ Sign _Sprinkler _ Demohtion_Change of se <br />DESCRIPTj9OFWORK r Ile provide the back), <br />foe- <br />dyel . <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typoof Project: _New ­Addis _Alteration _Repair <br />Type of Protect: _New _Addn —.Alteration _Repair <br />Show Number (a) of fixtures <br />Show Number (M of fixtures <br />Atc -lair handling units <br />I Toilet <br />Bathtub <br />I Fdreedairs stems <br />Gas piping <br />wash basin) <br />LavatoShower <br />Water heater <br />I Shower <br />Kitchen sink 8 disposal <br />Gas fireplace <br />_ <br />Dishwasher <br />Gas range <br />_ <br />I Clothes dryer <br />I Ciolhes washer <br />_ <br />Water heater <br />Range hood <br />Exhaust fan <br />Sink (servicelbarfmop/etc <br />Backgow prevenler <br />Heal pump <br />Unit neater <br />I Urinal <br />Boiler <br />Drinking Fountain <br />I Refrigeration <br />Floor drain <br />Woodstove <br />I Grease trap <br />Ducting <br />I Roof drains <br />Other <br />Medical Gas <br />J <br />Other <br />SPRINKLER 1 SUPPRESSION SYSTEM <br />Number of Heads <br />j Other. <br />I hereby cents that l have read and examined this appl:caton and know the same to be "a and correct Ali provisons of laws and ordinances governing this type of wine will be compled <br />W,h whether spewed herein or not. The granling of a peoni does hot prewme 10 give authority to violate or cancel the provision of any other stale a local law regulatng construction <br />That I J�a.,,ortzed tryr ov ner of this property to performthe work for which applkalmh Is made and I comply with the State Conuaclors Law 1a 27 RCW and 2962DUA WAC.crizod Agent Signature Date (Revised3/2013) <br />