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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: ���� �'tJ-� n�� ,��:rr,�rF�i-r�CC� r�,,L PROPERTYTAX# I PERMIT# <br /> �1 litlN•. �r[J 2�'�c>5��t�.�c��o.z�-rC'�C <br /> LEGAL for new construction: Short Plat/subdivision C����/L��YI�(_Il_��2 '_Lot No. �� (attach copy of long legal description) <br /> �t/�� 1�l� �� ���iCil1 S ti h r � ;G �iLI71 iEiCOlyli7lL�]r r7C'�.CC»1 <br /> OWNER �(�+�n��,IV11�� Phone/E-mail a�5� ����, �t���� �n�/ <br /> Address ►L��5 C�'��ti "�`� �G-� 5 I_ `� City/State/Zip l�l,����-�.L F' C�,f� ��37 3 <br /> CONTRACTOR ` �''�I�1�1�� CCI`n�11�J1)l�� L&I Lic.# ���1�n�1— �.-.� ��j 7 �� U <br /> Address ��C�'�� �-r��'� e'ti � �/��` � 1"4'���C4���� `7�j.� Phone/Email C2'S3)8`[� ILI�LC� x�O� ,, <br /> � � l_3 mu��si� �T,�r'n� %m;ec�,r�m,�u��b�� <br /> TENANT BUSINESS NAME CONTACT FOR PERMIr � � •i c�,� <br /> m,�►2��,�� v�r�s���M�� (�s.3)�3ir� ��;tio����.� <br /> Phone/E-mail I)ZVfU/1511L�'i,(� �7P° l�:(('(Wj,��l/1l h'/i/�• ('C�/y'1 <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Existing Use of Building_��� HEAT SOURCE: <br /> Proposed Use of Building 5�NG� f�}/nl�_12��1 C/�,�[� 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): � <br /> Cn����l,�tcrior� � c:i �e.v �`i�1�� ��rn,��-J 1�o✓Y�- , I�G�.�`J' <br /> Have you started working without a permit? YES�NO �2?'v <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project: �New_Addn _Alteration_Repair Type of Project: x New_Addn _Alteration_Repair <br /> Show Number(#)of fixfures Show Number(#)of Fxfures <br /> A/C—air handling units � Toilet � <br /> ' Forced air systems I �, � Bathtub <br /> 3 Gas piping � Lavatory(wash basin)�}���j <br /> ' Water heater � Shower I <br /> Gas fireplace � � Kitchen sink&disposal <br /> ► Gas range � � Dishwasher <br /> ` Clothes dryer � � Clothes washer <br /> I � Range hood � � Water heater <br /> � Exhaust fan ��-K Sink(service/bar/mop/etc.) <br /> � Heat pump � Backflow preventer <br /> � � Unit heater � Urinal <br /> � Boiler Fj�' Drinking Fountain <br /> Refrigeration Floor drain <br /> Woodstove � Grease trap <br /> j?� � Ducting I � Roofdrains ((�,�� <br /> �`� Other �� Medical Gas <br /> � <br /> �SPRINKLER 1 SUPPRESSION SYSTEM � Other: <br /> �/j 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 p pvisi ❑ y ot r state or local law regulating construction or the performance of construction.That I am authorized by the owner of this property <br /> to pe rm e wo for hich application is made and I comply with the State Contractors Law 1827 RCW and 296200 WAC <br /> i'' �� �C;(:�I?,C�i�r `-�1��I 1 <br /> Owner uthorize Agent ignature Date (Revised 2/2011) <br />