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PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810— FAX 4,^.5-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM —�' — <br /> E ADDRESS: VROPERTY TAX p PERMIT� <br /> � i � C�GD�+n' /✓ ,J, —C�. <br /> LEGAI lor new consiruction: ShoA PlaVsubdivislon Lol No.� (atlach copy of iong legal Eescription) <br /> i <br /> O NER t:' '�:r' - ! C� Pbone/E-mail � � - ^��%- ,�j '/7 <br /> i � /� <br /> AAdress c�Of�r/ /'v FI Cily/State/Zip </�/,'�f/ I `y 9�'a� / <br /> CONTRACTOR :�J • � !-.� L 8 I Lic.k <br /> / <br /> Address Phone/Emait 4��- 7.��.53�� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION coNTRACT PRICE oF WORK <br /> Ezisting Use of 8uilding HEAT SOURCE: <br /> Proposed Use of Building Gas Electric Other <br /> Building type: _Single Family _Duplex_Townhouse _Multi-Family _Commercial <br /> Type of project: _New _Addilion _Remodel _Repair_T.I._Sign_Sprinkler_Uemolition_Char.ge of Use <br /> DeSC�iplion o(WOrk(addifional space provided un fho back): <br /> Nave you atarted working without a permil7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of ProJect: _New_Addn _Alteratlon_Repair Type o1 ProJect: _New_Addn _ANeretlon_Repair <br /> Show Num6er(N)a!/ixfures Show Number(M)ol/Ixfures <br /> NC—air handling units Toilet <br /> Forced air s stems BathtuG <br /> Gas piping � Lavatory(wash basin) <br /> Water healer I Shower <br /> Gas lireplace Kilchen sink 8 dis osal <br /> �as range Dishwasber <br /> Clothes dr-er Clothes washer <br /> Ranye hood Water heater <br /> Exhaust fan Sink(sen��ce/badmop/etc.) <br /> Heat pump Dackflow preventer <br /> Unit heater Urinal <br /> 6oiler Drinkin Pountain <br /> Reln eration Floor drain <br /> Woodstove Grease trap <br /> � Dudin Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSIOH SYSTEM other: <br /> � Number of Heads I Other: <br /> I hereby certily Ihal I have read and e.amined Ihis applicatlon and know Ihe same to be ime and correcl.All provisions ol laws end orEinances Boveming <br /> �his type ol work will 6e complied with whether specilied herein or no�.Tha granting ol a permil 0oes not presume to give authoMy lo violate or cancel <br /> ihe provision of any other state or local law regulaling wnstmclion or fhe peAormance ol construction 7ha1 I am aolhorized by the owner o1 this property <br /> tr pertonn the work lor which application is mado and I comply with Ihe Slate Contraclors L.aw 18.27 RCW and 296200 WAC <br /> OwnerlAuthorizetl Agent Signature Dale (Revised711011) <br />