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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 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SIT DRESS: / <br />PROPERTY TAX tt <br />P MIT # <br />LEGAL for new construction: Short Plat/subdivision <br />_Lot No. (attach copy of long legal description) <br />OWNER !V/'/" <br />Phone/E-mail <br />Address— <br />City/State/Zip <br />CONTRACTOR <br />L & I Lic. # <br />Address <br />Phone/Email <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK ` CO U <br />Existing Use of Building Z;444yE ,�S7.�rAG� <br />HEAT SOURCE: <br />Proposed Use of Building Cann-4G 1,S7orAG <br />Gas_ Electric Other <br />Building type: X Single Family _ Duplex _Townhouse _ Multi <br />-Family _ Commercial <br />Type of project: _ New _ Addition _ Remodel _ Repair _ <br />T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />Description of Work (additional space provided on the back) : <br />m G 4/4 f/ 0 n " -(0 ,,/ 5007 <br />mac(' �✓i�� C/��iS/-,., <br />Have you started working without a permit? YES NO <br />C�r'r r r! r" `% i'"' fl 4�' <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New _Addn _Alteration _Repair <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Toilet <br />Forced air systems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />Heat pump <br />Backflow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing <br />this type of work will be complied with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel <br />the provision of any other state or local law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to perform the for which application is made and I comply with theWStateont:-ctorsLaw 18.27 RCW and 296.200 WAC <br />Owner/ horized Agent Si nature (Revised 212011) <br />