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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CI i Y 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 I <br />0W r vk <br />PRG?ERTY TAX # <br />00S -yo 0oo u <br />PERMIT # <br />LEGAL for new construction: Short Plat/subdivision f`I / Aa- Lol No.= (attach copy of long legal description) <br />OWNER FLr <br />Phone/E-mail <br />Address <br />City/SlatelZip <br />CONTRACTOR (-I G (_. _�,,._ <br />I : I Lic. # -t - T2TT '10,2LE <br />Address Phone/Email <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT J� <br />PhonelE-mail (, L S) <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK -I <br />Existing Use of Building S f �1 <br />Proposed Use <br />HEAT SOURCE: <br />Gas___ Electric_ Olher - wav( Stc,.r_ <br />``off/Building <br />Building type: X Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of project: _New _Addition _ Remodel _ Repair_ T.I. _ Sign _Sprinkler Demolition_ Change of Use <br />Descrip\lion of Work (a .tional spacfe provided on the back):_ <br />C. .- V 1 L? i.J;�3 I'Id r^r- . FJtJr(- Alu, ✓ Po v -t - <br />Have you started working without a permit? _YES Y ,NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _Now _Adds _Alteration _Repair <br />Show Number (#) of fixtures <br />Typo of Project: _`low_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />_ <br />A/C - air handling units <br />Toilet <br />Forced systems <br />Bathtub <br />piping <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />_ <br />Gas fireplace <br />Kitchen sink 8 disposal <br />Gas ran a <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water healer <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />Heat pump <br />Backilow preventer <br />Unit heater <br />Urinal <br />_ <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />_ <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />hereby certify that I have read and examined this application and know the same to be two and correct. All provisions of laws and ordinances governing <br />this type of work will be complied with whether specified heroin or not. The granting of a permit does not presume to give authority to violate or cancel <br />the provision of any other slats ocal law regulating construction or the performance or construction. That I am authorized by the owner of this property <br />to perform the work for w Id pplication is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />t • ZG-zu I <br />Ownor/Aul id Agent Signature Date (Revised 1212010) <br />