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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 />SITECAp� RES� l Sl1 i UJV i t <br />PRQPT�'X�CXX�Z 3U <br />PERMIT #D a O <br />LEGAL for new construction: Plat/subdivision <br />Lot No. (attach copy of long legal description) <br />fS'hort <br />OWNER � We- `>7/ZLAL' I[Z t t-LL <br />Phone/E-mail <br />Address ZCV L-�`&' 0. -j-[Z /Do <br />City/State/Zip <br />CONTRACTOR C"O f <br />L & I Lic. # <br />Address 2 I f <br />D2-0 i <br />Phone/Email <br />Z5Z- I <br />TENANT BUSINESS NAME <br />CONTACT F PERMIT <br />Phone/E-mail ` 2- 1((/ MAf1� ►'VlL✓<I,C'Cvh <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK C•atrc?�� <br />Existing Use of Building d0 (t 'f <br />HEAT SOURCE: <br />Proposed Use of Building rvt` C <br />Gas Electric Other <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi -Family -� Commercial <br />Type of project: _New /K Addition —Remodel —Repair_ <br />T.I. _Sign _Sprinkler —Demolition—Change of Use <br />Description of Work (additional space provided on the back) : <br />V )L' V � �7aij i �� �t (�15 h✓ ►� f Qr N� <br />`-)QhT I t' CP - <br />Have you started working without a permit? _YES V< NO <br />r-1..S: S Lx (I\Z o Lq IILW +�i CL-i <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New -j —Addn _Alteration _Repair <br />Type of Project: _New _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />Show Number (#) of fixtures <br />A/C - air handling units <br />Toilet <br />Forced air systems <br />Bathtub <br />P Gas piping <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (service/bar/mop/etc.) <br />Heat pump <br />Backflow 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 />I Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />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 granting of a permit does not presume 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 />top orm h work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />Owner/Authorize nt Signature Date (Revised 212011) <br />