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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLERIDEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />SITE ADDRESS:f <br />PROPERTY TAX # <br />PERry11T # <br />LEGAL for new construction: Short Plat/subdivision Lot No._ (attach copy of long legal description) <br />OWNER l v C- ;ref DC�T//./�/� <br />Phone/E-mail <br />Address/e,7 �'��,,ieXY ✓f <br />/I /�/� p 7 <br />City/State/Zip r r/>` /c' a O L 0/r <br />CONTRACTOR C'! <br />L & I iic. # <br />Address3/C'� (D C,(j / nL�(- f lC�J% �J Cv Phone/Email <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT <br />�nN n/FiF <br />o <br />PhonelE-mail y7 J S Op 6 3 C <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building 5fie HEAT SOURCE: <br />Proposed Use of Building 5ZI-1 Gas ✓ Electric_ Other_ <br />Building type: _ Single Family _ Duplex TTownhouse —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 bath): <br />r <br />G✓� T�l�2i�Ar��l A/ <br />ZO <br />Have you started working without a permit? _YES <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _Now_Addn _-.Alteration _Repair <br />Typo of Project: _Now_Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Show Number (#) of fixtures <br />A/C -air handling units <br />Toilet <br />_ <br />Forced air systems <br />Bathtub <br />_ <br />Gas piping <br />Lavatory (wash basin) <br />_ <br />Water heater <br />Shower <br />_ <br />Gas fireplace <br />Kitchen sink & disposal <br />_ <br />Gas range <br />Dishwasher <br />_ <br />Clothes dryer <br />I Clothes washer <br />_ <br />Range hood <br />Water heater <br />_ <br />Exhaust fan <br />Sink Is <br />_ <br />Heat pump <br />Backffow preventer <br />_ <br />Unit heater <br />Urinal <br />_ <br />Boiler <br />Drinking Fountain <br />_ <br />Refrigeration <br />Floor drain <br />_ <br />Woodstove <br />Grease trap <br />_ <br />Ducting <br />Roof drains <br />_ <br />Other <br />Medical Gas <br />_ <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other <br />Number of Heads <br />— <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 hereir 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 />I v 1 or which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />n <br />Owner/Author d onl Signature Date (Revised 12,2010) <br />