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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 h PERMIT. <br /> f 2 -7 112.E ST -5E 42 L4.&—:p.. I LL - 0014LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER Phone/E-mail <br /> Address City/State/Zip <br /> CONTRACTOR '.7 I 51 C::'J x,2'i t C_a 5 L&I Lic.# rj(?5f'• (S =`-1 c/CPQ • <br /> Address 1✓x-212 i3L7 HLLL--C-q t2 ETF I1,,-y t:754 MILL.C{7-{"x_ 1/,"t\ Phone/Email 5• :jC'. 010C'' <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> rr12_-Ft,. k C<'r.► L .S <br /> 5yLVANI LE,r41z01tJC' b_- 12 Phone/E-mail -11. :),3c-• f`� iL•C, /L 1SIci E'-i'zsi1 <c?sv'1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK if 2,1• 70.60 <br /> Existing Use of Building CC.rrr oE2Ct.}L- HEAT SOURCE: <br /> Proposed Use of Building cX�t lE: Gas Electric_ Other <br /> Building type: Single Family Duplex_Townhouse _Multi-Family )( Commercial <br /> Type of project: _New _Addition Remodel _Repair_T.I.X Sign_Sprinkler Demolition Change of Use <br /> Description of Work(additional space provided on the back): <br /> IN`>T.'LL_ ONE"- 1.-C t-0 VO LT/Dr&c (J0 siLtJ J15p,...F}y <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 <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 provisio \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 t work for which -.. atisn j made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC ) <br /> Z <br /> 'I"(l0fit onzed Age Si - re Dat (Revised 12/2010) <br />