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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CedarBt., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />r -7 n CG Boor WAT1nuS ARF ACCEPTED FROM 8 AM TO PM <br />/ r <br />SITE ADDRESS: <br />PROPERTY TAX <br />P MIT# <br />r D3 - �3G <br />LEGAL for new construction: Short Plailsubdivision Lot No._ (attach copy of long legal description) <br />OWNER — e, elle <br />Phone/E-mail <br />Address <br />City/State/Zip <br />CONTRACTOR ire.� c, i <br />L & I Lic. # ;rout k �' 17 92 �' ! c' <br />Address vim' l IGh C. ke.A4 W4 cf/ hone/[mail 2,)6, 229 52 `/j <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />Fff-?eIIc- , <br />Phone/E-mail 1 <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK \ Ts 1, r"b <br />Existing Use of Building HEAT SOURCE: <br />Proposed Use of Building Gas_ Electric_ Other_ <br />Building type: _ Single Femily —Duplex _Townhouse _ Multi -Family Commercial <br />Type of project: _New _Addition A,�_ Remodel _Repair _ T.I. _Sign _Sprinkler _Demoliticn_Change of Use <br />Description of Work (additional spaceprovided ontheback) : <br />Have you started working without a permit? _YES _,e NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _Now tAddn _Alteration _Repair <br />Type of Projec': _Now _Addn _Alteration _Repair <br />Show Number (#) 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 />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />j 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 / P—OPPRESSION SYSTEM <br />Other: <br />Number of Heads 1 S <br />Other: <br />1 hereby certify that I have read and examined this application and know the same to be two 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 conslmclion or the performance of construction. That I am authorized by the owner of this property <br />to perform the work for which a plicallon Is made and I comply with the Stale Contractors Law 18.27 RCW and 296.200 WAC <br />! '3�afl1C <br />Owner/Authorized Agon Signature `\Date (Revised 220r 1) ` <br />