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PERMIT APPLICATION <br />BUILDING/MECHANICAUPLUMBING/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 O <br />SITE ADDRESS: <br />PROPERTY TAX # <br />PERMIT 0 <br />LEGAL for new construction:Short Platisubdivision Lot No.__ (attach copy of long legal description) <br />// <br />OWNER netd A/' tie / vP <br />Phone/E-mail <br />Address let 5 T' /7�n, r <br />City/Stale/Zip 6✓frP� 1,4q <br />�� /L1 <br />e?'�. S. Ly& I Lic. # - ei M /W <br />CONTRACTOR i,7s, <br />uC. <br />�o <br />Address f.V ho O 1 ,--4rE..s{C w+5 (i✓� LL foJ Phone/Email <br />TENANT BUSINESS ZME <br />curt CTjFOR PERMIT <br />n <br />C Ili E <br />Phonmfil `i�i�� <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas Electric-K Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />Type of project: __ New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolition_Change of Use <br />Description of Work (additional space provided on the back): <br />_ <br />Have you started working without a :,ermll7 _YES �>/—NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _Now_Addn _Attentlon ][Repair <br />Show Number (#) of fixtures <br />Type of Project: _New _Addn _AltentlonyRepatr <br />Show Number (0) of flxturea <br />A/C — air handling units <br />lir <br />Toilet <br />Bathtub <br />Forced airs stems <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 servioe/barlmop/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 />Greasetrap <br />Cuctin2 <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER <br />/ 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 work forymjch ap on is made and I comply with theStateContractors Law 18.27 RCW and 296.200 WAC <br />Owner/Authorized Agent Signat Date (Revised 22011) <br />