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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 mvim.everettvii <br />2'3-/ <br />SITE DD E S: r� e� <br />PROPERTY TA%d <br />P �IT <br />��lytC <br />(/VJ <br />LEGAL for new constructionShort Platisubdivision Lot No _ (attach copy of long legal description) <br />OWNER L.f <br />An EiIfrtS <br />Phone/E-mail Zip - 3 3 0 <br />Address Ser li C <br />CilylSlalel2ip o W(q 17 <br />APPLICANT Owner _Owners Agent _Contractors Agent _Tenant lmun;nywJGoatoner ormmem trommoewneru powers in no space) <br />_Contractor <br />CONTRACTOR JWW-Sil lAr' G <br />State Lic. # <br />/C. %Wcity Bus. Lic. # <br />Address (/ Q f U1 PhonelEmail <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building POOL HEAT SOURCE - <br />Proposed Use of Building Gas` _ Electric_ Other__ <br />Building type: "X— Single Family Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of project: V New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolilion_Change of Use <br />DESCRIPTION OFWORK (additional space provided onthe back): 1�a-S Holum bins <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project: New _Addn _Alteration _Repair <br />Show Number (M) of fixtures <br />Typo of Project: _New __Addn _Alteration _Repair <br />Show Numbertrill) of fixtures <br />NC - air handling units <br />I Toilet <br />! Forced air systems <br />Bathtub <br />Gas piping <br />I Lavatory (wash basin) <br />I Water heater <br />Shower <br />Gas fireplace <br />I Kitchen sink S disposal <br />I Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer _ <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (servicelbariniop/etc ) <br />Heat pump <br />I Backilow presenter <br />Unit heater <br />I Urinal <br />Baler <br />I Drinking Fountain <br />I Refrigeration <br />Floor drain <br />Woodslove <br />Grease trap <br />Ducting <br />I Roof drains <br />Other <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other <br />Number of Beads <br />Other. <br />I hereby Cori I have read and e.amined this application and know the same to be true and correct All proms'ons of laws and ordinances governing this type or work evil be complied <br />wrh whether specified herein or not The granting of a print does not presume to give authority to violate or cancel the provision of any other stale or local law regulating conslrvction <br />That I am authorised by the owner of this property to perform the work for which split whon I5 made and 1 compy wrh the Slate Contractors Law ie 27 RCW and 296 200A WAG. <br />)v <br />Owner/Authorized Agent Signature Date <br />(Rovised 32013) <br />