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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBINGISIGN/SPRINKLERID�MOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everelt, WA 98201 - 425-257-8810—FAX 425•257-8657—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: . PROPERTY TAX N ERMIT 1! <br /> � :� � � <br /> LEGAL lor new ronstmction�. Short PlaUsubdivision Lo�No._ Iatlach copy ol long Iegal descnption) <br /> OWNER '� L Zb '1 � ( Phone�E-mail V <br /> Address ' � J i. CAyISIale2iP [�'�.✓1 �( � ��� � lJ <br /> CONTRACTOR � J '�� L 8 I Lic.!J <br /> Atltlress Phone/Ert•ail <br /> TENANT B1151NES5 NAME CONTACT FOR PERMIT�,��,,� '��77�,Y�w.� ({��Y/(.���L <br /> ✓ <br /> PhonME-mail �f1-) . —�S��r <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK // `�-� <br /> Existing Use oi Building '7' <br /> ^ HEATSOURCE: <br /> Proposed Use of Building Gas_ Electric Other_ <br /> Building rype: �Sinc�le Family _Duplex_Townhouse _MultrFamily _Commercial <br /> Type ot proirct: _New _Addition _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change o1 Use <br /> DescripfionofVlork(additionalspaceproridedonlhe6ackJ,; �� g ��u���✓ /7�7� <br /> { l• I FX�ShrirJ 5����r cni J�,i.��c_ t�r+�, << �j�cfr�Y vi s,,.,�i y �—i <br /> 2crn�c � <br /> Have you started working without a permit7 _YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type ol ProJecC _Nex•_Atldn �Alteratlon_Repair Type of ProJect _New_Addn _Alteration_Repalr <br /> Show Number(p)o(firtores Show Number(pJ ol/ixtures <br /> A/C—air handlin uniis Toilet <br /> Forced air s stems Bathtub <br /> Gas pipin Lavalor (wash basin) <br /> W ater heater Shower <br /> Gas�ireplaca Kitchen sink 8 disposal <br /> Gas r2n e Dishwasher <br /> Gothes d er Clothes washer <br /> Rangr,hood Water healer <br /> � Exhausl lan Sink(servicelbadmopletc.) <br /> Heat pump Backllow preventer <br /> llnil hcaler Urinal <br /> Boiler Drinkin Pounlain <br /> Relri eration Floor drain <br /> 1'Joodslove Grease trap <br /> Ductinq Roof drains <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM other: <br /> � Number of Heads Other: <br /> I hereby cehi/y Ihat I have�ead and exanuned this npplicalion and know the same to be Irue and correct.All Drovisions of laws and ordinances goeeming <br /> Ihis type ol wvrk w�ll be compiied��tn whelher specifietl herein or not.The granting ol a permil does not presume to give aulhoriry to violate or cancel <br /> ihe provision ol any olher stale or local law regulating consWction or lhe pedormance of conslruclioa That 1 am aulhonzed�y lhe owner o�lhis propehy <br /> lo perlorm Ihe work lor wh�ch appliwUon is made and I comply x+lh Ihe Sla�e CoMradors Law 1B.27 RCW Tnd 29G.2�0 WFC <br /> � <br /> %>. 1 i �✓, /l� ` 1 / �/ �� i/ <br /> Owner/AulhbHzed Agem Signaturo � �r Date (Revised 2/2071) <br /> ��� <br />