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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRIN KLERIDEMOLITION <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:� --J. `�(.l ]�' s�- PROPERTY TA%n P MIT# <br />J� <br />LEGAL for new construction Shod PloVsubdiiviision ____Lot N//o __ (attach copy of long legal description) <br />OWNER .�l �L�.l j 'Q. <br />PhonolE�mac .355` S�y <br />F1f�. <br />Address 1 � ( <br />Cit ISlale/Zp / Cir n - r - T <br />f�n�\/ <br />et COF �ti�l� Liicc...# tiJL/w C r�11 $ (a k� <br />CONTRACTOR , <br />G �L8II <br />M <br />Address !.� (( r / _ /`�'�- Milk 41 pftr�J <br />-(7 <br />TENANT BUSINESS NAME <br />C NTAGT FOF�PERMIT (Aet <br />PhonclEmail (• r1� �` <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />HEAT SOURCE: <br />Existing Use of Building <br />Proposed Use of Building Gas Electric Other <br />Building type: Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />_ <br />Type of project: _ New _ Addition _ Remodel _ Repair _ T.I. _ Sign _Sprinkler _Demolilion_Change of Use <br />Description of Work (additional space provided on the back) . <br />Have you started working without a permit? __YES <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _Now _Addn _Altorallon _Repair <br />Typo of Project _Now _Addn _Alteration XR.palr <br />Show Number # of fixtures <br />Show Number(#) ofllxturas <br />_ <br />A/C - air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Lavatorywash basin <br />Gas In <br />Shower <br />Water heater <br />Kitchen sink 8 disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />Clothes d er <br />Clothes washer <br />Ran a hood <br />Water heater <br />Exhaust fan <br />Sink (service/bar/mop/etc)- <br />Backgow re venter <br />Heat um <br />Urinal <br />DrInkino Fountain <br />Unit heater <br />Boiler <br />Relri oration <br />Floor drain <br />i <br />Woodatove <br />Graeae ire <br />Ductin <br />Roof drains <br />I <br />Other <br />Medical Gas <br />Other: WIi S Z� R-0 <br />d2L <br />SPRINKLER I SUPPRESSION SYSTEM <br />1 <br />I Number of Heads <br />Other: <br />1 hereby certify that 1 have read and examined this app,.:ation and know the same to be true and correct. All provisions of laws and ordinances goveming <br />does not to give authority to violate or cancel <br />this type of work will be complied with vrifether cihed or not. The granting of a permit presume <br />renetfu:lion or the performance of construclion. That I am authorized by the owner of this property <br />the provision of any othh�tele o ogu <br />to padorm 1 rk rn ode e 1 amply with St to Contractors Lew t8.27 RCW and PB8200 WAC <br />� <br />�13t t <br />Owner/Aulhortxad Agent Signature Date (Rewsed Y101 t) <br />