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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 />CATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br />APPLI <br />PERMIT # <br />SITE ADDRESS: <br />PROPERTY TAX # <br />LEGAL for new construction: Short Plagsubdivision Lot No.. (attach copy of long legal description) <br />OWNER G ` u l- -'� f'taTo <br />Phone/E-mail <br />Address <br />II1City/Slale/Zip <br />CONTRACTOR Guca&y2,t"j `3„'TT- ,t-( Tt4L—_L&ILic.f# C-VtVZ 6"f?022oi <br />21 � A-' L vrSYL07T r1 b90 PhonelEmail r42�_2SZ-'IIt4 <br />Address ZJ root<, utjn <br />TENANT BUSINESS NAME <br />"ONTACT FOR PERMIT <br />o PC,1­-k5 f-u-t9 n^V�5 IPhone/E-mail <br />tl-bAVC <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK Aon G k <br />Existing Use of Building_ tZ`o HEATSOURCE: <br />Proposed Use of Buildirg t.-Ccol Gas_ X Eiecidc SC Other_ <br />Building type: Single Family _ Duplex _Townhouse _ Multi -Family �L Ccmmerr-ial <br />_ <br />Type of project: _ New _Addition _ Remodel _ Repair_ T.I. _ Sign _Sprinkler_Demolition_Change of Use <br />Description of Work (additional space provided on the back): <br />� <br />�'f15 PoT CYL-c oiVe (Yr% AraC AIi4iN �� i-'' kr v�-) <br />06 2 4r4pt I� l-2-TU I A% <br />(nReIAL-I <br />pev V. * )1,j 'S-CDU6' ' --y <br />Have you started working without a permit? _YES ENO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project: _Now_Addn 1< Adoration _Ropair <br />Typo of Project: _New_Addn _Alteration _Ropalr <br />Show Number(#) of ffxfuros <br />Show Number (#) of fixtures <br />2-A/C—airhandlingunits <br />Toilet <br />Forced airs stems <br />Bathtub <br />Lavatory (wash basin) <br />Gas piping <br />Shower <br />Water heater <br />Kitchen sink & disposal <br />Gas (replace <br />Dishwasher <br />Gas range <br />Clothes washer <br />Clothes 6ryer <br />Water heater <br />Range hood <br />Sink (.ervice/bar/mop/etc.) <br />Exhaust fan <br />Backflow preventer <br />Heat pump <br />Unit heater <br />Urinal <br />Drinking Fountain <br />Boiler <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />1 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 slate or local law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to perform the work for which application is made and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />,GwowlAUthbTrzod Agent Signature Date (Revised 22011) <br />Ch <br />Ce)� <br />