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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 /> SITE ADDRESS: PROPERIY 7AX# P�RMIT# <br /> •� _�i 7 '� � . . , -� . . .- � ' '� ��� 9�i �.s'� <br /> .., �?-' v i <br /> LEGAL for new construction: Short Plat/subdivision Lot No. (attach copy of long legal description) <br /> OWNER '� ' = _ PhonelE-mail - �- �� -J •� <br /> - - - - <br /> Address t � f ;� ,,_ ,' City/StatelZip i , .>: � � � �, <br /> APPLICANT:r'Owner _Owner's Agent _Contractor _Contractor's Agent _Tenant(musi pro�ide a iener ofconsemfrom u,a owner io do wonc in ine space� <br /> CONTRACTOR L&I Lic.# COE Bus.Lic.# <br /> Address Phone/Email <br /> TENANT BUSINESS NAME CONTAGT FOR PERMIT <br /> _'.�- >7''- "��y•:; <br /> Phone/E-mail - - ,,.�-f�/ r � <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK ", ');)'s <br /> Existing Use of Building '--n•-� �•— ��.,... ��� � '�; ,`� > HEAT SOURCE: <br /> Proposed Use of Building �-F• �-�` - �. .<.:: �� _ Gas= Electric Other <br /> Building type: ��. Single Family _Duplex Townhouse`_Multi-Family _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): s'� S,F L/Vld.t.'v SP� <br /> .- `` '' >�; �4- % _, ',�� ._ . - - - g� s� ����� <br /> \ 2�� S;F d�GK <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(#)o(fixtures Show Numbei(#)of fixtures <br /> A/C—air handling units Toilet <br /> Forced air systems Bathtub <br /> Gas piping � Lavatory(wash basin) <br /> Water heater d Shower <br /> Gas fireplace Kitchen sink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> � 3 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 this rype of work will be complied <br /> with whether specified herein or not.The granting of a permit does not presume to give authonty to violate or cancel the provision oi any other slate or local law regulating construction <br /> That I am aulhorized by the owner of Ihis property lo perform the work for which applicalion is made and I comply wilh the State Contractors Law 18.27 RCW and 296.200A WAC. � <br /> ,i .� . � I7 / <br /> !/ <br /> ' Owner/Authorized Agent Signature Date (Revised 6/2012) <br />