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PERMIT APPLICATIA <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 />s- <br />SITE ADDRESS: <br />- '�A 982 <br />LEGAL for new construction: Shod Plat/subdivision <br />PROPERTY TAX # PE IT # <br />SO S--o t31mm <br />Lot No._ (allach copy of long legal description) <br />OWNER f-+—t',` S <br />PhonelE-mail <br />0 <br />i <br />Address <br />Cily/Statelzip <br />APPLICAN Owner A Ownoes Agent _Contractor _ Contractors Agent Tenant (must provide a lever of contend hem the (Nmer to do won h the space) <br />CONTRACT( <br />State Lic. # City Bus. Lic. # <br />Address <br />Phone/Email <br />TENANT 13USINES5 NAME: <br />/�//1'�1t 1, <br />S <br />CONTACT FOR PERMIT <br />N /G <br />PhonelE-mail aa, X0 3 s9 <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK 00 U <br />Existing Use of Building <br />Proposed Use of Building <br />Building type: _ Single family _Duplex _Townhouse _ <br />Type of project: _New _ Addition Remodel _ Repair <br />HEAT SOURCE: <br />x/ Gas —Elect- dc Other_ <br />Multi -Family f= Commercial <br />_ T.I. _ Sign _Sprinkler _Demohtion_Change of Use <br />DESCRIPTION OF WORK (additional space provided on the back): <br />� J <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Type or Project: _New_Addn Alteration_Repair <br />Show Number (#) of ixtures <br />A/C — air handling units <br />Toilet <br />Forced air systems <br />Bathtub <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 lan <br />' Sink (service/bar/mop/etc.) <br />Heal pump <br />B-ackflow preventer (inside bldg) <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodslove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other. <br />I hereby codily that I have read and examined Ihis appllra0on and knew the same to be lve and contact. All provisions of laws and ordinances governing this type of work will be complied <br />vrlh whelher specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provision of any other slate or local law legulaung construction <br />Thal I a )herbed by the o a ollhis property to pedorm the work rot which appticiUon is made and I comply with the Slate Contractors Law 10.27 RCW and 206.200A WAG. <br />w erl/luthor' g tt Signature Uale (Revised 412015) <br />