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MIIIIIIIIIII <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/S!GI/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 8 AM TO 4 PM <br />SITE D RES J PROPERTY TA%# PERMIT <br />t <br />LEGAL for new construction: Short Plat/subdivision Lot No._ (attach copy of long legal description) <br />OWNER v ' r Phone/E-mail <br />y� <br />Address 1V �% Z- '�-, City/Stale/Zip r f2 / <br />CONTRACTOR r L & I Lic. # <br />Address Phone/Email <br />TENANT BUSINESS NAME CONTACT FOR PERMIT <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />E -ic-; Use of Building 7 HEAT SOURCE: <br />Proposed Use of Building_ f Gas Electric_ Other <br />Building type: ,Single Family _ Duplex _Townhouse _ Multi -Family _Commercial <br />Type of project. _ New _ Addition _ Remodel ,_ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />Description of Work (additional space provided on the back): <br />Have you started working without a permit? _YES _NO <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _Now _Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repalr <br />Show Number (#) of fixtures Show Number (#) of fixtures <br />A!C — air handling umts Toilet <br />Forced au systems Bathtub <br />Gas pipin Lavatory(wash basin) <br />Walerheater Shower <br />Gas fireplace Kitchen sink & disposal <br />Gas range Dishwasher <br />Clothes dryer Clothes washer 94 <br />Range hood Water heater <br />Exhaust fan Sink (service/bar/mop/etc.) <br />Heat pump Backflow, preventer <br />— Unit heater Urinal <br />� Boiler linking Fountain <br />i2efri eration Floor drain <br />Woodstove Grease trap <br />Ducting Roof drains <br />Other Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM Other: <br />Number of Heads Other: <br />I hereby certify 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 type of werx 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 r local law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to erform the work for vhi 1 lication is made and I comply with the State Contractors Law 16 27 RCW and 296 200 WAC <br />p P <br />(Revised 211011) <br />Owner/Authorize, Alton[ Signature <br />