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PERMIT APPLICATION <br /> BUILDING/h1ECHANICAL/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 /> APPLICATIONS ARE ACCEPTED FROM B AM TO 4 PM — a 3—� Z <br /> PROPERTY TAX p PERMIT t <br /> SITE ADDRESS: z n� _ <br /> r•-� <br /> LEGAL for new conslruclio : Shoh Plat/su6division Lot No._ (altach copy ot long legel description) <br /> OWNER ��� � � PhonefE-mail dc� ^ � zQ— ��� � <br /> Address — <br /> �..EC _ ��C CitY/State zU'� <br /> APPLICANT:�Owner Owner'sAgent Contractor ConlraelofSAgent _Tenant�mmio��aea�enormw,semwmuwwnenoaowae�nmesp,ca) <br /> CONTRACTOR � L 8 1 Lia# COE Bus. Lic.# <br /> PhonelEmail <br /> Address <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PronelE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK � <br /> Ezisling Use of Building ������Cl'"��/' S � HEAT SOURCE: <br /> Proposed Use of 8ui ' � ( J� Gas_ Electnc_ olher_ <br /> Building lype: _Single Family _Duplex_,Townhouse _Multi-Family _Commercial <br /> T pe of pro'ect: New _Addition Remodel _Rzpair_T.I. Sign_Sprinkler Demolilion Change of Use <br /> DESCRIPTION OF WORK�additionelspeceprovidedon(hoback): � � � � '"}1.,(�;` <br /> \J' � `' ' <br /> �Cff(Q�_=Z� � ����C. � ` <br /> �5�°�c�—.�—� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJect: _Now_Addn _Altoratlon_,Repalr Typo 01 ProJocl� Show Number(M)o/(lxtutrestion_Repalr <br /> ShowNumber(N1 o/fixfurcs <br /> A/C—air handlin units '�' ' Toilet <br /> Forced air syslems Bathlub <br /> I Gas piping �� Lavarory(wash basin) <br /> i Water heater � Shower <br /> Gas fireplace ( I Kilchen sink 8 disposal <br /> Gas ran e ', Dishwasher <br /> Clothes dryer I Clothes washer <br /> Range hood I Water heater <br /> Exhaust fan I Sink(service/bar/moplelc.) <br /> Heat pump I Backflow preventer <br /> � Unit heater � Urinal <br /> I doiter I �rinkin Fountain <br /> Refri eration � Floor drain <br /> ' � Grease trap <br /> Woodstove <br /> Ducling I Roof drains <br /> Other � Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM ', other: <br /> Number of Heads � Other: <br /> 1 here0y certdy that I have metl bad exeminetl this ap�lica;ion entl know I�e eama to be Irue end correct.AA Drovisions ol laws antl oMinances goveming t�is type ol work mll be comp4etl <br /> with�enmher spealietl herein or not.Tho granlin a permit doee nol presume tc give autnorAy to v�olate or wncel t�:pmvision ol any other stata or lowi law reeulcting wnswabn � <br /> Tpal l am authorizetl by Iha owner oltl�i�prope y to perto �ne work lor xTich appliafon ie ma a enE I mmO�Y�vith t�e State Contrectors lew 7127 RCW an0 296 TOOA WAQ � � <br /> . <br /> � � L ` l � (Revised 6/2012) <br /> OwnodAuthod�� A l� ignaturo Dale <br />