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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 — v✓ww.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />1 � <br />ROPERTY 7AXp <br />fro 90J 3 01 %c) o <br />PE MI A <br />- <br />LEGAL for new construction: Short Plat/subdivision Lot No._ (attach copy of long legal description) <br />OWNER'f% mv-r. Co�Tcr­ LLB <br />Phone/E-mail <br />Address 'j 92 7{ Z o b' /'L f f a� <br />CIIylStale/ZiP L <br />CONTRACTOR Sjf 41 Jew. ✓ r-c_. L & I Lic. # , LTI <br />Address I.I v-tif��/� 1 � u�' L r r " y I Phone/Email .2 <br />TENANT BUSIIN/�S NAME (?�I•��} CONTACT FCR PERMIT c�yS�rn sr•C, 9•cC•N <br />�fib Ze s C 4C �. `I Phone/Email CC / Jakr9 W A-yB/, .2 TT.S-2z <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK t 6 00 °- <br />Existing Use of Building _&ATA .d.wl HEAT SOURCE <br />Proposed Use of Building 2enXitM wr,-T _ _ LGas_ Electric_ Omer__ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi -Family 251Cr mmercial <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 />ated a—i� '� + a cdC. a G 6 i%� j - f3 + d�y'L t r T �✓ v /�Cu rn r _ i e <br />Have you started working without a permit? _YES _,-_NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn —Alteration _Repair <br />Show Number (#) of [xtures <br />Type of Project: _New_Addn _Alteration_Repair <br />Show Number f#) of fixtures <br />_ <br />A/C- air handling units <br />Toilet <br />_ <br />Forced air systems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Waterheater <br />Shoer <br />v <br />_ <br />Gas 6rc lace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />_ <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />Heat pump <br />Backllow preventer <br />_ <br />Unit heater <br />Urinal <br />_ <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />_ <br />Grease trap <br />_ <br />Ducting <br />Roof drains <br />Oliner <br />Medical Gas <br />SPRINKLER <br />/ SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />I hereby certify tha' I have read and examined tms 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 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 />O erlAulhorlaod Agent Signature r� - Date <br />(Revised 122010) <br />I.a <br />