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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 />/) _ 1 C C .00r it n-nnrac noF errFPTFn FROM a AM TO 4 PM <br />SITE ADDRESS: _ - <br />PROPERTY TAX 11 <br />PER � O <br />LEGAL for new construction: Short Plattsubdivision Lot No._ (attach copy of long legal description) <br />OWNER <br />Phone/E-mail <br />Address <br />City/Slate/Zip <br />CONTRACTORr 5 Q i Gt— <br />L & I Lic. # <br />I( <br />n '/ �^' ,609 b Phone/Email <br />Address I" v 'J li'� I f^ f�^ 4�Uauv <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />CONTACT <br />l �'�. C LS C h I L 0 (� <br />Phone/E-mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building C ns__ Electric_ 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 />Have you started working without a permit? _YES _NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _Now_Addn _.Alteration __Repair <br />Type of Project: _Now_Addn __Alteration _Repair <br />Show Number(N) of fixtures <br />Show Number (#) of fixtures <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 />I <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />I Water heale: <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />Heat pump <br />I Backflow prevenler <br />Unit healer <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Roof drains <br />Ducting <br />Other <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />1 <br />Other:' ce M Nwa <br />Number of Heads <br />Other: <br />1 hereby certify that I have read and examined this application and know the some 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 for which application is made and I comply with the State Contractors Law 18.27 RCW and 296,200 WAC <br />d l 3" ";l <br />(Revised 22011) <br />Owner/Aulhodzed Agent Signature Date <br />