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PERMIT APPLICATION <br />BUIL.DING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES S —I Z <br />3200 C-�c ar St. Everett. INA 98201 - 425-257-8810 - FAX 425 257-8857 - wv. �verettwa.Org � <br />APPLICATIONS ARE ACCEPTED FROM 6 AM TO 4 PM � 20 —L.l)Y� <br />SITE ADDRESS' <br />PROPERTY TAX a �L/� <br />PEFVIT u <br />LEGAL for new construction Short PlaVsubdrvisio ____ tot No, . -__ (attach copy of long legal description) <br />OWNER <br />PhonelE-mad <br />2 <br />Address l air �J7j� <br />n.1.1 <br />GnylStatelZip (`j - /(J 1 1 I�' (teat <br />// <br />CONTRACTORtfi <br />- <br />.�dan.•,; L ✓� r'e <br />Fhonc En:el / /T7 <br />�k3S <br />TENANNT�BUSINESS NA t: 0 / ,/���"{'' <br />CONTACT FOR PERMIT <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building ___. _.. HEAT SOURCE: <br />Proposed Use of Building__ __ Gas Electric __ _ Other_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi•Fa;mmil�Y� Commercial <br />Type of project: __ New __ Addition _ Remodel _ Repair _ T.1. Sign _Sprinkler _Demolition —Change of Use <br />Description of Work (additional space provided on the back): <br />o <br />Have you started working without a permlt7 ___YES X, NO /'rill s76*7. <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: New ... Addn _ .Alteration Repair <br />Show Number (p) or fixtures <br />Type of Project: _ .New --Addn -Alteration Repair <br />Show Number (($) or fixtures <br />A/C — an handling units <br />Toilet <br />Forced ads stems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />Range hood <br />Water heater <br />Exhaust fan <br />Sink (servicelbarfmo letc.) <br />Heal pump <br />Backllow preventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floor drain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />Other <br />Medical Gas <br />SPRI KLER I SUPPRESSION SYSTEM <br />Other: <br />Number of Heads <br />Other: <br />I hereby certify, that 1 have read and examined this application and know the same to be two 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 296200 WAC <br />Owrer1AAhorizec17qent5nnature Da (Revisad?/20t1) <br />tiIz <br />