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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DENIOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Ceder St., Everett, WA 98201 -425-257-8810 - FAX 425-257-8857 - www.everettwa.org <br />rev •nneeren cone a AM Tn A Pax 3 —1 L " I I <br />SITE ADDRESS: ,. Iv <br />PROPERTY TAX <br />gpi�AlT - O� <br />IV I 0 3 <br />. <br />LEGAL for now construclion: Short Plagsubdivision Lot No._ (site& copy of long legal description) <br />OWNER 5->r C Phone/E-mall r' <br />Address /y `"" L,-r — <br />City/State/zip <br />CONTRACTORAI) rz,lif­.1;00'� <br />O- <br />,. <br />Address .e� `,i. i, Phone/Finail <br />r'r,. :, <br />TENANT BUSINESS NAME <br />CONTACT OR PERMIT t E 17 <br />'i ' <br />Phone/E-mail r I ' • ,•'�^ <br />BUILDING PERMIT APPLICATION <br />ICONTRACT PRICE OF WORK <br />Existing Use of Building r C, 1 r \ HEAT SOURCE: <br />Proposed Use of Building rat 6' (Lk )'s'� Gas ' Electric Other <br />Building type: Single Family _ Duplex _Townhouse _ Multi -Family Commercial <br />_ <br />Type of project: _ New _ Addition _ Remodel __ Repalr*2�­ T.I. _ Sign _Sprinkler —Demolition—Change of Use <br />Description of Work (addilbnel apace provided on the beCiJ� � I n <br />I , ,,! �''' r'•�\-��"�.t li,�� (O�p,�-PLC s•"/t/_ r-JfZ( <br />.(JY�]'.'y�t,/ �� <br />Have you started working without a permit? ___YES -'NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: !&New_Addn b♦tlleretlon_Repair <br />Type of Pro}eel: _New_Addn _Alteration_ Repair <br />Show Number a of axtures <br />Show Number fOi of fixtures <br />NC - air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />Gas piping <br />Lavatory wash basin <br />Water heater <br />Shower <br />Gas firel <br />Kitchen sink 8 disposal <br />Gas ramate <br />Dishwasher <br />Clothes d r <br />Ciolh@a waaher <br />Range hood <br />Water heater <br />Exhaust tan <br />Sink service arInlo letc. <br />Heat m <br />Backgow prevenler <br />Urinal <br />Unit healer <br />Boller <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Root drains <br />Other <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other: <br />Number of Header <br />Olher: <br />I hereby candy that I have reed and examined this application and know the same to be two and corned. All provisions of laws and ordinances govurmng <br />this type of work will be complied wth whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel <br />the pro nsmn of any other stale a local law regulating construction or the performance of construction That I am authonzed by the owner of this Property <br />to perform the work for which application is made and I comply with the Slate Contractors Law 16 27 RCW and 296.200 WAC <br />l °P i �//t /?ti l l <br />Owr orfAulMAted Agent Signature Data (Revised nor f) <br />