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PERMIT APPLICATION <br />BUILDING/P.9ECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., EverEll, WA 98201 425-257-8810 FAX 425-257-8857 www.everettlisi <br />APPLICATIONS ARE ACCEPI ED FROM 8 AM TO 4 PM <br />SITE ADDRESS: <br />PROPERSY TAM # <br />PERMIT p <br />'�C _ <br />e N <br />LEGAL for new construction: Short Plat/subdivislon Lot No._ (at'ach spy of long legal description) <br />OWNER .0 IIiL_Iil C-",7 C L\ <br />PhonetE-mail <br />11) /�� <br />Address {� V f l aR d v✓ ?� <br />City/State/Zip Gt/t <br />APPLICANT: A—Owner_Owner's Agent Contractor Contractor's Agent _Tenant /must goride•lenor ofwmemhoni ma awswrro do.cn lane swat <br />CONTRACTOR w ,V Z ; L & I Lic. # COE Bus. Lic. # <br />Address Phone Email <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />OiG Jt C LI HEAT SOURCE: <br />Existing Use of Building <br />Proposed Use of Building c j^' • /t (� Gas A' Electric Other_ <br />Building type: Single Family _ Duplex _Townhouse _ Mult - miry _Commercial <br />_ <br />Type of project: New Addition —Remodel Repai T.I. Sin Sprinkler _Demolition Chan a of Use <br />_ <br />DESCRIPTION OF WORK (additional space provided on the back). <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Type of Project: _Now _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Show Number(PI) of fixtures <br />AIC — air handling units <br />, Todet <br />Bathtub <br />Forced airs stems <br />Gas piping <br />i Lavatory (wash basin) <br />Water heater <br />I Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Dishwasher <br />Clothes washer <br />Gas ran a <br />Clothes dryer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (setvicelbar/mop etc.) <br />Heat pump <br />Backflosv preventer <br />Unit heater <br />Urinal <br />Boiler <br />/ Drinkinq Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />( Other: <br />Number of Heads <br />Other: <br />I hereby canny that I haveread and examined this application and know ma same lobe two and correct. All provivons of laws and ordinances governing this into of' In& wrs to cc mpLed <br />with whather specified heminyr not. The granting of a penult does not presume to grins authority to violale or cancel the provision of any nther stare or local Law regulating conslroction <br />That I am euthod(ya,by th)✓owoer of this property to perform me work for which application Is made and I campy win me Slate Contractors Low 18 27 RC W and 296 200A WAC. <br />(Revised 62012) <br />