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PERMIT APPLICATION <br />BUILDINGIMECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425 257-8810 FAX 425-257-8857 www.everettwa.org <br />SITE ADDRESS: -TN <br />PROPERTY TAX g <br />PE MIT I <br />r <br />fi/ <br />LEGAL for new consbucliorc. Short PlaVsubdivision -Lol No—_ (attach copy of long legal description) <br />OWNER Phone/E mail <br />City/Stale/Zip <br />Address <br />APPLICANT:_Owner _Owner's Agent Conhaclor — Contractors Agent _Tenant tmvt prondaalenarWm�.an nom me w.rormoo won n nv aparal <br />CONTRACTOR (O �r state Lic. fl r It Bus. Lic. / <br />Address Phones[mail <br />TENANT BUSINESS NAME CONTACT FOR PERMIT pd, <br />1 PhonelE-mail `F2 rium <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br />HEAT SOURCE <br />ExiMing Use of Building — — <br />Gas Electric Other <br />Proposed Use of Building <br />Building type* Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />_ <br />Addition Remodel .[ Re air T.I. Sin S rinkler Demolition Change of Use <br />Type of rli ect New <br />DESCRIPTION OF WORK (additional space pmvidedo� beck): <br />o�yRPT R I)Cz1. / <br />PLUMBING PERMIT APPLICATION <br />MECHANICAL PERMIT APPLICATION <br />Typo or Project: <br />_Addn __Alteration _Repair <br />Typo of Project: _Now <br />_Adcln __Alteration _Repair <br />_Now <br />Show <br />Number i) of fixtures <br />Show <br />Number (#) of flxfuros <br />Toilet <br />A/C - air handlin units <br />Forced airs stems <br />Bagdua <br />Lavatory (wash basin <br />Gas i in <br />Shower <br />Water heater <br />Kitchen sink & dis osal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />Clothes washer <br />Clothes dryer <br />Water heater <br />Range hood <br />Sink servicelbar/mo /etc. <br />Exhaust fan <br />W v <br />BaCK10reenter <br />Heat pumpI <br />I Urinal <br />Unit heater <br />Drinking Fountain <br />� Bciler <br />Floor drain <br />Refrigeration <br />Grease trap <br />Woodstove <br />Roof drains <br />Ducling <br />Medical Gas <br />Other <br />SPRINKLER I SUPPRESSION SYSTEM <br />I Other <br />Number of Heads <br />Other. <br />I hereby candy that I have road and examined this applKehon and know rho some to be two and correct AN pmvhoons of laws and ordinance• govemmg his type of work wit be compiled <br />with whether specified herein or not. The giving of a permd dose not presume to give authority to violate or cancel the provision of any other state x local uw regulating comhuctnin <br />Thai 1 am soheraed by the owner or this pmperty to perform the work for which epplKal on is made and I empty with the Slate Contractors Law to 27 RC W and tea 20DA WAC. <br />44w. - - (RevisedW013) l <br />OwnertAutherleed Agonl Ignaturo Date <br />