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• ! <br /> 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: ROPERTY TAX# PERMIT# <br /> 3003 It) t s,n G I 'Cod 4- % ev gi00 a/0 0 Z� rn% 11 .--/4 <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER C7Z, - , CO Phone/E-mail 412 5 3z/ L - C-/ 27/ <br /> Address ) X) City/State/Zip rf 2//i 53>Z0 / <br /> �C 3 S �:� �=5��n n <br /> z-f <br /> CONTRACTOR ci'f o�✓/7�, c ^cf. Gr•'a✓,/� L`&I Lic.# "J rG���,.,�j�Q,/�T <br /> Address /0/ Z_ C !e_�f« / Ai/L /tc S� „t !�/t /o 032 Phone/Email lac-Z4- 6/)OL,,D�/)/r7\ )Ivc:G .6z <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> / 1 J <br /> Phone/E-mail 1 tyles in , /J Orf`j (1i/vg.e ,Cale <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK/ S�JG0c) <br /> Existing Use of Building (/:i HEAT SOURCE: <br /> Proposed Use of Building Cael //ec ...c_e_ Gas Electric Other <br /> Building type: Single Family Duplex Townhouse Multi-Family /C Commercial <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 /> /1724 <br /> Have you started working without a permit? YES NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: New Addn 7K Alteration_Repair Type of Project: New Addn Alteration_Repair <br /> Show Number(#)of fixtures Show Number(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping Lavatory(wash basin) <br /> 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 /> Ducting Roof drains <br /> Other Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM Other: <br /> Number of Heads 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 /> 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 /> Owner/Authorized Agent Signature Date (Revised 2/2011) <br />