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PERMIT APPLICATION <br /> BUILDiNG/MECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <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 /> SITEAD RESS: PROPERTYTAXp P RMIT# <br /> D ^ — <br /> LEGAL fo� new construclion� Short PlaVsubdivision Lot No._ (atlach copy ol long Iegai descriplion) <br /> OWNER � �J✓l ��l G V�\ Cs� Phone/E-mail — �� � � � ` <br /> Addmss J� . r..S'� �� City/Stale2ip / O�/ d <br /> CONTRACTOR ��� 1 � D `M� � L&I Lic.# <br /> Address PhonGEmail <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> PhonclE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE UF WORK <br /> Existing Use ot Building HEAT SOURCE: <br /> Proposed Use of Building Gas _ Elecuic_ O�her_ <br /> Building type: _Single Family _Duplex_Townhouse _Mulli-Family _Commercial <br /> Type of project: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Description of Work(additional spaceprovided on fho back): <br /> Have you staAed working witliout a permil7 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo o(ProJect: _Ni�w_Addn _Alteration_Repalr Typo of ProJecl: _Now_Addn _Alteration_Repalr <br /> Show Num6er(p)ol lixfures Show Number(N)o/�ztures <br /> A/C—air handling unils Toilet <br /> Forced air sysiems Bathtub <br /> Gas piping � Lavatory(wash basin) <br /> Water healer Shower <br /> Gas fire lace I Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes d �er Clothes washer <br /> Range hood Water heater <br /> Exhaust fan Sink(servicelbar/mop/etc.) <br /> Heat pump Barkflow preventer <br /> � Unil healer Urinal <br /> Boiler Drinking Founlain <br /> Refriyaralion Floor drain <br /> Woods�ove Grease trap <br /> � Ducling Roof drains <br /> � Other Medical Gas <br /> SPRINK[.ER / SUPPRESSION SYSTEM Other: <br /> IN�rt:ber of Heads I Other: <br /> I hereby certify that I have reaJ and examined this application and know ihe same to be We and conecL All pmvisions ol laws and ordinances goven�ing <br /> ihis lype ol�vork�vill he complied with whether specified herein or noL The granting ol a permit does not presume lo give authori�y to violale or cancel <br /> Ihe provision ol any other state or local law regulating constroction or the pedomiance of constmction.Thal I am authodzed by the owner ol ihis propeity <br /> to pertorm the work(or which ap�Iicaiicn i;maae antl I comply�vaii;,`,e Stale CoMractors Law 18,27 RCW and 296.200 WAC <br /> � vi�, � �Z 'e?_ G// <br /> O edAuthorizpd' ont5lgnaturo Date (Fevised2/2011) <br /> � <br />