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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 - 4254j7-8810 — FAX 425-257-6857 — www.everettwa org , / <br />C.2" Aool ICATIONR ARE ACCEPTED FROM 8 AM TO 4 PM I &b"7 <br />SITE ADDRESS:. _ <br />PR�jRTYTAKR <br />• S_I�JLal <br />lAJ <br />LEGAL for new construction Start Plat/subdwisbn______—_ <br />No._ <br />(eltach copy of long legal description) <br />O W N E R <br />Phone/E-mail <br />Address �lJ )� <br />City/State/21p <br />CONTRACTOR <br />L 8 I LIc. 0 <br />Addres.�/55 d <br />s / Il/{/ <br />,�� <br />t� Phons/Email <br />TENANT BUSINESS NAME <br />'�- <br />CONTACT FOR PERMIT 'S ,JI <br />Phone/E man L -) ' <br />BUILDING PERMIT APPLIZATION <br />r <br />CONTRACT PRICE OF WORK <br />Existing Use of Building _____----- _ <br />Proposed Use of Building --- __---- —_ -__ <br />Building type: ___Single Family __ Duplex __Townhouse Multi -Family �mmerciai <br />Type of project: __New Addition --Remodel _ Repair _ T.l.A Sign __ <br />Description of Work (adddana/ space pmvlded on fire beck): <br />Haw you started working without a permit? -YES _ _YES NO <br />HEAT SOURCE: _ <br />Gas___ Electric___ Other___ <br />Sprinkler ___Demolition_ Change of Use <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project. New Addn Alteration _ Repair <br />Rxlunts <br />ShAGas <br />Type of Project: <br />.Now .Addn Alteration Repair <br />Show Number a of fixtures <br />handlingunits <br />Toilet <br />rs stems <br />Bathtub <br />Lavato wash basinaler <br />Shaver <br />lace <br />Kitchen sink & dis sal <br />a <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust an <br />Sink service/ber/mo /etc. <br />most pump <br />Backgow 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 I SUPPRESSION SYSTEM <br />Other: <br />Numher of Hoods <br />Other: <br />i hereby teddy that I have read and examined this application and know the same lobe 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 />I any other state of local law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to dorm or which application is made and I comply wllh the State Contractors Law 18 27 RCW and 296.200 WAC <br />Owoor/Authorised Agent Signature Oate - (Revised 212011) <br />