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PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <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! AM TO 4 PM <br />SITE AD ES <br />C <br />PROPERTY TAXR <br />PCERMITIN <br />LEGAL for new construction ShortPlat/subdiviston Lot No —L (attach copy of long legal <br />OWNER <br />Cdescnptlon) <br />Phone/E+nail <br />address <br />- <br />cdylSlatdLp Ametj <br />WN C <br />APPLICANT: A� Owner OWneis Agent _Conuaclor _ Contractofs Agent _Tenantnmmprwaeannnormmwnrm tee owinmao wannma sw®) <br />CONTRACTOR <br />{� <br />L& I Lic. tt L COE-Blus. Lic. 006173 <br />Address O <br />Phone/Email <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Eaisling Uso of Building Iti <br />HEAT SOURCE <br />11I <br />Proposed Use of Budding 1 Il P ' Gas Electric_ Other_ <br />Building type. 1L Single Family _ Duplex _Townhouse _ Mulb-Famdy _Commercial <br />Type of project Now _ Addition Remodel Repair _ T I _ Sign __Sprinkler --Demolition Change of Use <br />DESCRI P11ON OF WORK (addlional space provided on me hack) <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Projoct: Now _Addn _Attention _Repair <br />Show Numbs (0) of filatures <br />Type of Project _VNew _Addn _Alteration _Repair <br />Show Numher (9) of Ravana <br />A/C - air handling units <br />Toltec _ <br />Forced air systems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water healer <br />Shower <br />Gas fireplace <br />Kitchen sink A disposal <br />Gas tango <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Walor healer <br />Ezhausl fen <br />Sink (service/bar/mopfetc.) <br />Heal Pump <br />Barkllow prevenlar <br />Unit healer <br />Urinal <br />❑oiler <br />Drinking Fountain <br />i <br />Refrigeration <br />Floor dram <br />Woodstove <br />Grease (rap <br />Ducting <br />Roof drains <br />Other _ <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />Other <br />corn <br />I hereby Will that I have reed and exam lied this oplikelbn and know the same lobe two and correct All provisions of laws and union antes gove min this type of won will be comptad <br />with whether specifed hereon or not the granting of a penne does not presume to give authority to violate or cancel the provision of any other store or local tow regulating consbucenn <br />Thal I am avOorued by Ne owner of this property to perform the work for which application K made and I comply ssth the State Comrades Law 18 21 RCW and 236 200A WAC <br />4v-� f q-14 <br />OwnerlAuthorli ed Agent SlgnaSaro Date (Revised 62012(11 <br />�IZ <br />