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PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBFNG/SIGN/SPRINKLER/DEMOLITION <br /> C1TY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810— FAX 425-257-8857—www.everettwa.org <br /> 1 TIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> SIT ADDRES : � PROPERTY TAX# RMIT <br /> �vo3 � � c�s� 6-� ,!� i2 l�vCQ c�g <br /> LEGAL for new construction: Short PlaVsubdivision Lot No. (attach copy of long legal description) <br /> OWNER �(N Phone/E-mail <br /> Address City/State/Zip <br /> CONTRACTOR � � �o L&I Lic.# <br /> Address <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT <br /> �d�l f✓6 Phone/E-mail ✓/��--�� '✓'"•J,�.�J <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK I. ooc <br /> Existing Use of Building {��� H'EAT SOURCE: <br /> Proposed Use of Building M�� Gas_ Electric Other <br /> Building type: _Single Family _Duplex Tow�house ` ' Multi-Family �,Commercia( ' <br /> Type of project: _New _Addition _Remodei _Repair_�T.I._Sign_Sprinkier_Demolition_Change of Use <br /> Description of Work(additional space provided on the back): <br /> ./�-'�b 2 S E c 7'�e n�s o fl- (�A-c,��► (G/�-C K- <br /> Have you started working without a permit? YES �NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: _New_Addn _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 /> Neat 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 orthe performance of construction.That I am authorized by the owner of this property � <br /> to pert m the work for which a plication is mad nd I comply with the State Contractors Law 18,27 RCW and 296.200 WAC <br /> Owner/Authortzed Agent Signature / Date (Revised 2/2011) <br /> �Z <br />