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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CeY St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />(-= Annr rn Arrnuc ARP ArtCFPTFr1 FROM 8 AM TO 4 PM <br />SITE ADDRESS: . <br />PROPERTY TAX # <br />PERMIT # <br />K-I to 1 " 0OZ <br />LEGAL for new construction: ShortPlaIlsubdivlslon Lot No._ (attach copy of long legal description) <br />OWNER + gIIG <br />Phone/E-mail <br />Address <br />City/State/Zip <br />CONTRACTOR — c <br />L & I Lic. # ;rorn V- P c] 2 C c, <br />Address v " I b Sa- 1.4/a d/ honelEmail 2 6' 22 -7 52 `ij <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />Fit, 2ell<-�s <br />Phone/E-mail Ty - V- <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK \ Ic r, L. ^ "� <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas_ Electric_ Other_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi -Family Commercial <br />Type of project: _ New _ Addition 4,�- Remodel _ Repair _ T.I. _ Sign _. Sprinkler _Demolition_Change of Use <br />Description of Work (additional space provided on the back): <br />AV -Aa zz/,-S <br />Have you started working without a permit? _YES _,k_NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project: _Now 4Addn _Alteration _Repair <br />Typo of Project: _Now_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Slrow Number (#) of fixtures <br />A/C - airhandlingunits <br />I <br />Toilet <br />Forced air systems <br />Bathtub <br />^ <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 (service/bar/mop/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 />Grease trap <br />Ducting <br />[Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / PJAqPRESSION SYSTEM <br />Other. <br />Number of Heads t $ <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 slate 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 Stale Contractors Law 18.27 RCW and 296,200 WAC <br />Owner/Authorized AgentSignature Date /t (Revised 7/2017) (/� <br />