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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 - WNW.evere ttw erg` /' <br />S ARE ACCEPTED FROM 8 AM TO 4 PM <br />APPLICATION <br />SITE ADDRESS: PROPERTY 1A%4 PERMITIp �) <br />LEGAL for new construction: Short PleVsubdivlslon Lot No. (affect, copy of long legal description) <br />�7 Phone/E-mail <br />OWNER <br />City/Stale/Zip <br />C' <br />nudress� - <br />CONTRACTOR 1.J ��— 1.81 Lie. p <br />Phone,Email <br />Address <br />CONTACT FOR PERMIT <br />TENANT BUSINESS NAME <br />Phonc;E -mail <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />HEAT SOURCE. <br />Existing Use c(Bwlding-- <br />Ges Eleddc Other <br />Proposed U,e of Building -. <br />Building type: Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />_ <br />Type of project: _ New _Addition _ Remodel _ Repair_ T.I. _ Sign _Sprinkler _Demolition_,s C1henge of Use <br />Description of Work (additional space pmvideol m the beck): Ap+— N Lr �w � L �� VJA I - <br />1�vA ,� <br />%�L t2t1t�.I C� <br />Have you started working without a permit? _YES _ NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Projact: _Addn _Alteration _Repair <br />Typo of Projoel: _Now <br />_Addn _Alteration _Repair <br />_Now <br />Show Number N of Nxtures <br />Show <br />Number IN of fixtures <br />A/C - air handlingunits <br />Toilet <br />Forced airs stems <br />Bathtub <br />Lavatorywash basin) <br />Ges I In <br />Shower <br />Water heater <br />Kitchen sink 8 disposal <br />Gas fireplace <br />Dishwasher <br />Gas fen e <br />_ <br />Clothes washer <br />Water heater <br />Clothes dryer <br />Rene hood <br />Sink servieelbarlmop/ale <br />Exhaust fan <br />Backfiow, preventer <br />Heat pump <br />Urinal <br />Unit heater <br />Drinking Fountain <br />Boiler <br />Floor drain <br />Re Erallon <br />Gtease trap <br />- <br />Woodstove <br />Roof drains <br />Ductin <br />Medical Garr <br />Other <br />SPRINKLER I SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby certify that I have read and examined this application and know the some to be true and correct. All provisions of laws and ordinances governing <br />this type of work wil if complied will'A llher specified herein or not. The granting of a permit does not presume to give authority to violate or cancel <br />perVis on of any other state or local law (i?gulaling construction or the performance of construction. Thst I am authorized by the owner of this property <br />to perform the for h epplication/S made rid I mply with the Slate Contractors Law 18 27 RCW and 290 200 WAC <br />C - / (Revised 21201r) <br />/ I �c. <br />Owner/Authorized Agent Signalur <br />Date <br />0 <br />