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{ <br /> PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGNISPRINKLER/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 /> APPLICATION5 ARE ACCEPTED FROM 8 AM TO 4 PM � I <br /> SITE ADDRESS: VROPERTY TAX M PERMIT� <br /> pc YG lD�- <br /> LEGAL for new constiuction: Shor1 PIaVs�btlivision Lot No._ (attach wpy af long legal descnption) <br /> 04YNER Q� S� Phone/E-mail 7i-S �� � �Z <br /> Address 3 . A; 5 �!C'.� CilylSia�e2ip /�f <br /> CONTRACTOR ' L 8 I Lic.# <br /> Address �' • �C� G�,� Phone/Email Z,s',S��O' � <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Go,�y �-k��vc-z�as� �/�-s�3g <br /> Phone/t-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /� G� <br /> Ezisting Use of Building HEAT SOURCE: <br /> Proposed Use of duiiding Gas_ Eiectric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addition _Remodel _ReAair_T.I._Sign_,Sprinkler_Demolition_Change of Use <br /> Descrip�ion of Work(adtlilional space provided on(he back): <br /> j2,_,�l�ocs� r�^/ or�.fs ��`r��,� <br /> Have you started working without a pertnit7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJecl: _New_Addn _Alt�ratlon_Repair Type of ProJect: _New_Addn _AMentlor_Repalr <br /> Show Number(N)o//ixtures Show Num6er(It)o/flxtures <br /> AIC—air handlin units Toilet <br /> Forced air s stems Bathtub <br /> Gas iping Lavato (wash basin <br /> Water heater Shower <br /> Gas freplace Kitchen sink&dis osal <br /> Gas ran e Dishwasher <br /> Clolhes d er Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink(service/bar/mo /etc.) <br /> Heat pump Backflow prevenler <br /> Unil heater Urinal <br /> Boiler Orinkin fountain <br /> Refri eration Floor drain <br /> Woodstove Grease tra <br /> Ductin Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads Other: <br /> I hereby cerlity Iha�I have read and ezamined this application and know�he same to be lrue and corred.All provisions of laws an4 ordinances govem;ng <br /> this type ot wo!k will be complied with wlielher specifed herein or noL The graNing of a permit does not pres�me lo give aulhoflty to violate or cancei <br /> Uie pmvision ol any oiher slate or local law regulating consiruction or Ihe pedormance of conslrucfon.That I am au�honzed 6y the owner of ihis pmpedy <br /> to perform Ihe k for which applic ' n is matle a I cmnply wilh ihe State Contractors Law 1827 RCW and 2°6900 WrC <br /> wnerlAu�edAgentS ature � Ua`e � (RevisedY2011) <br />