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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGNISPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES 3 "�{j'�I?i <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 /> SITE ADDRESS: / ^ PftOPERN TAX p PERMIT t <br /> 1^�� S � <br /> LEGAL�or new wnslrutlion: Shoh PlaVsu�tlivislon Lol No._ (atlach copy ol long le9al desaiption) <br /> � � <br /> OWNER �(� � ohGE•mall <br /> dOress Ciry/Slale/Z�p W ��d 7'� <br /> CONTRACTOR L 8 I Lic.# I C L �( �O S - <br /> PhonGEmail <br /> Etlress <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �� P�one/E�mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE oF WortK <br /> Existing Use of Building HEAT SOURCE: <br /> Proposed Use of Building Gas_ Eiectric Ot�er <br /> Buildingtype: _SingleFamily _Duplex_Townhouse _Multi-Family _Commerciel <br /> Type of project: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Chan9e of Use � <br /> Description of Work�aaai�ional space povidea on the 6ack): pW nGl� 50.�15 SC�� �s n0'� L OnnEG��' <br /> pe,nnc� S FP� s� no need � caP o� <br /> Have you started working wilhout a permit4 _YES _NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> 7ypeolProJecl: _New_Addn _Alteratlon_Repalr TypeolProJect: _Naw_Atldn _Alteretlon_Repalr <br /> Shaw Numbo!!p)o/llitures Show Number(N)ol flYfures <br /> qIC—zirhandlin unils Toiiet <br /> � Forceo air e slems Balhtub <br /> Gas pi ii� Lavato wash basin) <br /> � Waler heat>r Shower <br /> � Gas firepla-e Kitchen sink 8 dis osal <br /> Gas ren o Dishwasher <br /> — Clothes dryer Clothes washer <br /> Ran e hood Water heater <br /> Exhaust fan Sink service/barfmo /elc. <br /> Hea;pump I Backllow reventer <br /> Unit heater Udnai <br /> Boiler Drinkin Fountain <br /> Refri erat'on Floordrain <br /> Woodstove Grease tra <br /> � Ductin Roof drains <br /> � Other Metliwl Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Olher: <br /> � Number of Heads I Olher: <br /> I hereby cetliry that I�ave read and exa�ninetl Ihis appiicalion an0 know tne same to be lrue anU correcL All pmvisions of laws and oMinances goveming <br /> this typo ol�wrk wAI be camplied xrih whe�her speci(M herein or not.Tha granUng ol a permit dces not presuma to give aul�onty to violata or cancel <br /> t�e provision ol any ol�er slate or local law regitlating constmclion or t�e pedormance ol consWdion.That I am authorized by Ihe owner of tMs property <br /> to pedorm Ihe wo�k lor whicli epplicalion Is maC nd I comply wlt��he Slate Contracton Law 18.27 RCW and 298.300 WAC <br /> e�� f,r/ � 3�a �''o� o�a , . <br /> wnerlAulhodzed Agonl Signature �ate (Revised 7/201/) <br />