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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGNISPRINKLERIDEMOLITION <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 ADORESS: PROPERTV TAX tt PERh�I � � OZ.J <br /> 332 � o ' <br /> LEGAL tor new constmction� Short PlaVsu6drvision <br /> Lot No._ (attach copy of long legal desc�p�ion) <br /> OWNER '�S PhonelE-mail ' Z � O�`�'� <br /> Address <br /> CnylSta�e2ip �n I[ � <br /> CONTRACTOR L 8 I Lic. # <br /> Address PhonelEmail <br /> TENANT�USINESS NAME CONTACT FOR PERMIT <br /> PhonelE-mail <br /> BUILLIING PERMIT APPLICATION CONt'RACT PRICE OF WORK � � �'� <br /> Existing Use of Building Q/� \ <br /> HEATSOURCE: <br /> Proposed Use ol Building S� � STD F7^��c,J Gas_ Eiectrm_ Otner_ <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family �Commercial <br /> Type of projecC �New _Addition _Remodel _Repair_T.I._Sign�Spnnkler_Demolilion_Change oloUse <br /> DescriptionofWork(addrhonalspacepinvidedonfho6ack): N�y�/ �`�`N� l,,lJ�`1�1 �L��ON '"� <br /> £�1STlt1(ap STRu,LIT�R/�� �- �RA�f`1G. l�tlllJ LDhD1t�lC� DOG1L t�1�lD ADDtT�D�FL <br /> PQVE� 1 �1��� LV� htF7�H. Le(t o. Fo�1,av1 ��� f�ishn W�vi�l,t,`t� <br /> Have you started working without a permit? _YES �NO ,�� �{. ��r.o Syy Y �-!-✓.��� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Pralecl: _New_Addn _Alleratlon_Repalr Type of ProJec�: _New_Addn _Altera�ian_Repair <br /> Show Number(A1 0l l/xtures Show Number(fl)o!lxNres <br /> AIC—air handlin units Toilet <br /> Forced air s slems BalMub <br /> Gas pipin Lrvalo (wash basin) <br /> Waler healer Shower <br /> Gas freplace Kitchen sink 8 disposal <br /> Gas ran e Dishwasher <br /> Clolhes d er qothes washer <br /> Ran e hood Waten c�aler <br /> Exhaust fan Sink(servicelbarlmop/etc.) <br /> Hcat pump Backflow preventer <br /> Unil heater Urinal <br /> Bailer Drinkin Fountain <br /> Refri eration Floor drain <br /> Woodstove Grease lrap <br /> Ductin Roof drains <br /> Olher Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM o�her: <br /> INumber of Hcads O�her: <br /> I nereby cem(y thal I have read and eKammeO this apphcauon and know the same to be true and coRecL All provisions oi laws and ordinances goveming <br /> rt,�:s tyt�c ol vrork vnll be complred wnh whether speciLed herein or noL The g�animg of a pertnit does�ol presume to give aulhonty to violate or cancel <br /> u�u prcvision of any other state or lowl law regulaling constmclion or the pedortnance of consWction.That I am authorized by the ovmer ot this property <br /> U.,nerlortn lhe work fo�whlch apPliw6on 5 made�l comply u+lh the Stale Coniraclors Law 18.27 RCW and 296.200 WAC ' � <br /> � � - . ���`; � ���� ��"��u'( � (Revised2/2011) <br /> OwncdAinhorized Agent Sio�� �:,~� � Oale / � <br />