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I-ERMIT 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 L -_ -i `` <br />SITE ADDRESS: <br />ti N;l� 4 Ev ETi <br />- <br />LEGAL for new construction: Short PlaVsubdivision Lot No._ (attach copy of long legal description) <br />OWNER b(`A� L-,cC <br />F- <br />Phone/E-mail 3--t3 - LAE <br />ZJ <br />Address J Q H:'� <br />City/State/Zip <br />CONTRACTOR S;7AtL Qs ---LA <br />L & I Lic. # I .Or2 C...L0'q lL t'L - <br />Address Phone/Email <br />TENANT BUSINESS NAME <br />- <br />CONTACT FOR PERMIT /-- ( f i <br />Phone/Em Swl l�r 1 t �J1i k+Zf a U d 4d 2- f <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 -Family X Commercial <br />Type of project: _ New _ Addition _ Remodel _�C Repair _ T.I. _ Sign _Sprinkler _Demolltion_Change of Use <br />Description of Work (additional space provided on the back): <br />Rac t r�S eK eia <br />Have you started working without a permit? 4YES _NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Type of Project: _New_Addn __Alteration —Repair <br />Show Number (#) of fixtures <br />Type of Project: _New_Addn _Alteration_Repair <br />Show Number (#) of fixtures <br />A/C - air handling units <br />Toilet <br />Forced airs stems <br />Bathtub <br />_ <br />Gas pi in <br />Lavatory (wash basin <br />Water heater <br />Shower <br />Gas fireplace <br />Kitchen sink & disposal <br />_ <br />Gas ran a <br />Dishwasher <br />_ <br />Clothes dryer <br />Clothes washer <br />_ <br />Range hood <br />Water heater <br />_ <br />Exhaust fan <br />_ <br />Sink service/bar/mop/etc.) <br />_ <br />Heat pump <br />_ <br />Backflow reventer <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />Refrigeration <br />Floordrain <br />Woodstove <br />Grease trap <br />Ducting <br />Roof drains <br />_ <br />Other <br />Medical Gas <br />SPRINKLER / SUPPRESSION SYSTEM <br />Other <br />Number of Heads <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 stale or local law regulating construction or the performance of construction. That 1 am authorized by the owner of this property <br />to perform "ark.far-wIft, application is made and I comply with the Slate Contractors Law 18.27 RCW and 296.200 WAC <br />erl dhorized goof Signaturo D to (Revised 12/2010) <br />