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PERMIT APPLICATION <br /> BUILDINGIMECHANIGAL/PLUMBING/SIGN/SPRINKLERIDEMOLITION <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 /> SITEAODRESS: PROPERTYTAXp PERMIT/ �y � <br /> � I 3 I 5'h S i MAtZzr�� vsc- R <br /> LEGAL I�r new conslruclion: Short PlaVsubdivision Lol No._ (altach copy of long legal description) <br /> OWNER ��/ Phone/E�mail 4ZS 27'� <br /> Address � I 3� GAST I1'lhV��v� ��=W �2 CitylSlate/Zip EV�1Z�i� V�l/k <br /> CONTRACTOR TN — Sc+<.�LC � L 8 I Lic.# N l c..l- � <br /> Address ''" � 'rUN C PhonelEmail y�� ,�� • �/:3.�� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonelE-mail � yZ:j " � (✓ � `�.3 0 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK I�b.ou <br /> Exisling Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Electric_ Other_ <br /> Buiiding lype: Single Family _Duplex_Townhouse ,_Multi-Family ,_Commercial <br /> Type of project_New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Descriplion of Work(addrtional spaco provided on fhe back�: <br /> (LL LCc.A i tu��[ U i �..i.f `_, f��C"r�1L <br /> Have you started working without a permft7 _YES _NO <br /> MECFIANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> 7ypo of Project: _Naw_Addn _Altoratlon_Repair Typo of ProJucl: _Now_Addn _A: 'ntlan,_Ropalr <br /> Show Number(N1 oI lixfuros Show Number(N)o/flxtures <br /> A/C—air handlin units Toile� <br /> Forced air systems 8alhtub <br /> � Gas pipin Lavalory(wash basin) <br /> Water healer Shower <br /> Gas fireplace Kitchen sink&dis osal <br /> Gasran e Dishwasher <br /> Clolhes dryer � Clothes washer <br /> Ran e hood � Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Neat pump Backflow preventer <br /> Unit heater Urinal <br /> �oiler I Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodslove Grease hap <br /> Ducting � Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM Other: <br /> Number of Heads I Other: <br /> I hereby cettify that I have read and ezamined ihis application and know Ihe same to bo Irue and conect.All provisions ol laws and ordinances goveming <br /> this typo ol�mrk will be complied wilh whelher specifed herein or aaL Tho granting ol a permit tloes no�presumz b giva aulhodty lo violale or cancel <br /> the provision of any other state or local Inw regulaling construclion or Ihe pedormance oi consWClion.Tha11 am authorized by Ihe owner of lhis propeAy <br /> lo pedorm Ihe work tor which applicalion is made and I comply with ihe Stale CoNractors Law iB27 RCW and 296200 WAC <br /> /7 // �/�� <br /> j��' �' � �KA/'I`-+•<!" � —�/��/� <br /> Ownor/Authorfzod Ac�ont Signaturo /bale (Revised 7J2071) <br />