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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—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SITE ADDRESS: . PROPERTY TAX# PERMIT# <br /> � �� �r ; ;'-'.,,-.� G �U --UC�, <br /> ��I�� � ;�(��t::, ' u � 'l ;u,�: 41 �'; i�-. <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER �(?��,i'� �1 �.,- - Phone/E-mail �'-{��:i - �jl� ��-f� ;J���,�� r�'i'7E�� I,��, �� <br /> Address � �l �-.�.- �� City/State/Zip '� � , l �',. ��'j ZC.'' ( <br /> CONTRACTOR ' �._i:�1`� �� L&I Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> Phone/E-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building �.:��+L�t��h�: � HEAT SOURC�: <br /> > ' , . r' ., L ,�. <br /> Proposed Use of Building�'i :v:?�; �� f x f}r ., „•' t�" ,',�;<+ �<:�� Gas Electric_ Other_ <br /> Building type: J Single Family _Duplex_Townhouse _IVlulti-Family _Commercial <br /> Type of project: _New _� Addition ✓ Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> DeSCriptlOn of Work(additional space provided on the back): �Ll, , . , �:�-�,"�-';y ��:� �'�1 �� �,�y;- ��L ` " �- ' <br /> -i i • , J J <br /> ���t��Y`, a� � ;S !,', � : ��_ ✓ � , _�`7_ JGLC.'�.i�u2C� cc< {�c,�.l�VJv'Y�� '�'".G, f 1-j ��` � 4 1 <br /> i /� T <br /> i� ���1�� '� ft,i'�1� �' i�._ .il �.t'1" . V��cL��'�, 15Q�"c`lt�����;�`�C� �i1������ }�Iv.?�h.��'jc� ?'`� " <br /> Have you started working without a permit? _YES _NO , ��••�+ <. �.t'"; ,�,_j; r-- ..'. ; Z��". '+' � <br /> MECHANICAL PE RMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _Alteration_Repair Type of Project: � New_Addn =Alteration �=Repair <br /> Show Number(#)of fixtuies Show Number(#)of fixtures <br /> � A/C—air handling units � Toilet <br /> ( Forced air systems � Bathtub <br /> � Gas piping � Lavatory(wash basin) <br /> j Water heater � Shower <br /> ; Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer � Clothes washer <br /> � Range hood � Water heater <br /> Exhaust fan � � Sink(service/bar/mop/etc.) <br /> Heat pump � Backflow preventer <br /> Unit heater � Urinal <br /> Boiler Drinking Fountain <br /> � Refrigeration � Floor drain <br /> � Woodstove Grease trap <br /> I Ducting � Roof drains <br /> � Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM I other: <br /> Number of Heads I Other: <br /> I hereby certify that I have read and examined this application and know the same to be 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 grant ing of a permit does not presum e to give authority to violate or cancel <br /> the provision of any other state or local law regulating construction or the performance of construction.That I am authorized by the owner of this property <br /> to pe�fQrm the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br /> �/ � -- -�_i�iL�-_ j� f�- <br /> '�l i` ,� !/ � [ %%I ' Z_. <br /> �' t Date (Revised 2/2011 <br /> O.��/Aurth zed Agent Signature 1 <br /> . .�: `, <br />