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PERMIT APPLICATION <br />BUILDINGIMECHANICALIPLUMBINGISIGNISPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 - FAX 425-257-8857-www.everetMa.org <br />Baal IC-ATIONR ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS: <br />PROPERTYT R <br />PERMIT0 -r <br />�G <br />LEGAL for new construction: Short Platlsubdivision Lot No _ (attach copy of long legal description) <br />OWNER 1 <br />PhorelE-mail <br />n <br />Address P[_ <br />Citylstate2lp IVA <br />CONTRACTOR YY) <br />L 8 I Lic. 11 <br />Address Phone/Email L4 ZC�, - 7 <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />Phone/E-mail q 2 -7%S-G, <br />BUILDING PERMIT APPLICATION ICONTRACT <br />PRICE OF WORK <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas Electric X Other <br />Building type: X/Single Family _Duplex_Townhouse _Multi -Family _Commercial <br />Type of project: V New _Addition _Remodel _Repair_ T.I. _Sign _Sprinkler _Demolition_Ch''annge ofUse <br />Description of Work (additional specs provided on the back): yt/e� �i1-(GTLE$$ /T�fj'f—►'L(Il'lp <br />3"vS�-rill , <br />Have you started working without a permit? _YES X-NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn KAlteratlon_Repair <br />Show Number a of fixhlres <br />Type of Project: _New_Addn —Alteration_Repair <br />Show Number / of fixtures <br />A/C—airhandlin unit, <br />Toilet <br />airs stems <br />Bathtub <br />in <br />Lavatorywash basin <br />heater <br />Shower <br />lace <br />Kitchen slnk ddis sel <br />range <br />Dishwasher <br />s dryer <br />!Exhaust <br />Clothes washer <br />hood <br />Water healer <br />t fen <br />Sink servioelbarlmo etum <br />— C <br />Baddlow revemerater <br />Urinal <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 I 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 ordinerrcaa govemirg <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 provisio any other state or local law regulating construction or the performance of censWction. That I am suthorL-ed by the owner of this property <br />to perio thrork for which appli made and I comply with e Stfe Contractors Law 18.27 RCW and 296.200 WAC <br />Own (Revised 2R0111 <br />ho Agent Sig urc Date <br />