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P��iMIT APPLICATIO^� <br /> BUILDINC 1ECHANICAL / F'Ll1MBING / SIGN 'RINKLER/ DENiOLITIOfV <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET, EVERETT,WA 98201 <br /> (P)425-257-8810 � FAX 425-257-8857 �(E)everetteps@everettwa.gov� www.everettwa.gov/permits <br /> PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: • �,� ,,,� PROPERTY TAX#: <br /> G �. <br /> LEGAL for new construction: Short Plat/subdivision /�(1�'��,�i�'-�i��i� Lot No. � (attach copy of long legal description) <br /> CONTACT 1NFORMATION <br /> OWNER NAME: `� TENANT NAME(If Commercial): <br /> OWNER MAILING ADDRESS: sTrzE�r� � <br /> CITY � STATE � ZIP � <br /> OWNER PHONE: � t �� � �' OWNER EMAIL: `�Q 7 , � <br /> CONTRACTOR NAME; � , <br /> CONTRACTOR ADDRESS: sTReer <br /> �17y � STATE Z�P <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): � %�f �� �.r�. CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): � <br /> .. .. . , <br /> PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> ��. � CONTACT EMAIL: <br /> BUILDING PERMIT APPLICATION <br /> Existing Use of Building: � � Contract Price of Work:$ <br /> Proposed Use of Building: Heat Source: ❑Gas Electric ❑Other <br /> Building Type: SFR-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-#of Units: ❑Commercial ❑Industrial <br /> Type of Project: ew ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br /> DESCRIPTION OF WORK: <br /> -� �U/�c% // /1/�GJ ,.`1!_�\ G�'�� �/�/ ,�S"2�i� �C�� <br /> ASSOCIATED BUILDING PERMIT#(if applicable): <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: �New _ Addn _Alteration _Repair Type of Project: �New _Addn _Alteration _Repair <br /> #of Lisf of Fixtures #of Lisf of Fixtures #�f Lisf of Fixfures #°f Lisf of Fixtures <br /> Fixtures Fixtures Fixtures Fixfures <br /> A/C—Air Handling Units Heat Pump � Toilet Backflow Preventer(Inside Bldg) <br /> f Forced Air Systems -- Unit Heater �. Bathtub — Urinal <br /> Gas Piping — Boiler �''"" Lavatory(Wash Basin) — Drinking Fountain <br /> Water Heater Refrigeration Shower — Floor Drain <br /> Gas Fireplace — Wood Stove Kitchen Sink&Disposal — Grease Trap <br /> — Gas Range Ducting / Dishwasher •— Roof Drains <br /> Clothes Dryer Hookups Other: Clothes Washer ---- Medical Gas <br /> Range Hood Water Heater Other: <br /> " Exhaust Fan Sink(Service/Bar/Mop/etc.) Other: <br /> SPRINKLER/SUPPRESSION SYSTEM <br /> Number of Heads <br /> ACKNOWLEDGEMENT:I fiave reviewed fhis application and confirm the information contained herein is true and correcf. Work done pursuant to this permit must comply with <br /> currenf federal,state,and local law. The granting of a permit only authorizes app�oved work and no deviations therefrom.Devrafions musE first be authorized rn w�iting from the <br /> Building OSicral before berng aufhorized under any circumsfance.I am the owner,or I am authorized by the owner of this property fo perform fhe work for which applicatron is made, <br /> and l comply with the e nfractors Law 18.7_7 RCW and 296200A WAC. <br /> Cify of Everett Official Use Only <br /> PERMIT# <br /> � c����� C���� - b(D� <br /> Owner/Authorized Age t Signature Date (Revised 10/12/2095) z <br />