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3 <br /> 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 /> SITE ADDRESS: '' PROPERTY TAX q PERMIT#`(? ^r 2 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER -T kv\ V)-e_�� '✓-- Phone/E-mail <br /> Address A )j)--- 6 C)r� 5 t ,<j 1 City/State/Zip <br /> CONTRACTOR / L& I Lic. # - 3'4 7� � <br /> Address O U.)a./ Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK /G/45Z — <br /> Existing Use of Building c ,l 'c— HEAT SOURCE: <br /> Proposed Use of Building �9- l G Gas Electric Other <br /> Building type: Single Family Duplex Townhouse _Multi-Family Commercial <br /> Type of project: _New _Addition X Remodel Repair_T.I. Sign Sprinkler Demolition Change of Use <br /> Description of Work(additional space provided on the back): <br /> v. Ao C,(+rCt5 <br /> Have you started working without a permit? YES NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: _New_Addn _Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood ( Water heater <br /> Exhaust fan Sink(service/bar/mop/etc.) <br /> Heat pump Backflow preventer <br /> Unit heater Urinal <br /> Boiler Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove Grease trap <br /> Ducting ( Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads 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 /> top orm the work for whi applica'on is made and I comply with the Slate C ntractors Law 18.27 RCW and 296.200 WAC <br /> wner/Authorized Agent Signature /Dat (Revised 2/2011) <br />