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PERMIT APPLICATION <br />BUILDINGIMFCHANICALIPLUMBINGISIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everet �.Or <br />r(� <br />n nrcocn FROM a dM TO d PM <br />APPLiZANUNur Aii r vr. . .. _ <br />PROPERTY TAXN <br />SITE ADDRESS: <br />K <br />3A <br />SO I A <br />LEGAL for new construction: Shoo Fmt/subdivision____ Lol No._- (al(ach copy of long legal description) <br />OWNER LAIN iM LI4- <br />PhonelE-mail <br />IS:72a 63 A tN <br />City/State/Zip <br />/film <br />Address <br />CONTRACTOR^-71 M i c g�GL- 3>ANorl L& I Lic. # <br />Address / s T ZZ. �' )in AV e kJ Phone/Email <br />TENANT BUSINESS NAME <br />CONTACT FOR PERMIT M i L4-IEL - 7>ANor/ a Live *Coll <br />SuN2�G FAnjL iIEDrGAL C-An.E <br />Phone/E-mail 25 4/9 ZS 25 <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORE( S O60 _ <br />HEAT SOURCE: <br />Existing Use of Building <br />Gas_ Electric-- Other___ <br />Proposed Use of Building <br />Building type: Single Family _ Duplex _Townhouse _ Multi -Family _ Commercial <br />_ <br />Type of project: _New _Addition _Remodel —Repair _T.I. _Sign _Sprinkler _Demolilion_Change of Use <br />Description of Work (additional space provided on the back): <br />Have you started working without a permit? _YES _NO <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type of Project: <br />_Alteration _Repair <br />Type of Project: _Now _Addn _Alteration _Repair <br />_New_Addn <br />Show <br />Number (#; of fixtures <br />Show Number (#) of fixtures <br />A/C — air handling units <br />Toilet <br />Forced air systems <br />Bathtub <br />Lavatory (wash basin) <br />Gas piping <br />_I <br />Shower <br />Water heater <br />Kitchen sink & disposal <br />Gas fireplace <br />Dishwasher <br />Gas range <br />Clothes washer <br />Clothes dryer <br />Water heater <br />Range hood <br />Sink (service/bar/mop/etc.) <br />X <br />Exhaust fan 44 <br />Backflow, preventer <br />Heat pump <br />Urinal <br />Unit healer <br />Drinking Fountain <br />Boiler <br />/ Floor drain <br />Refrigeration <br />Grease trap <br />Woodstove <br />Roof drains <br />Ducting <br />Other <br />Medical Gas <br />Other: <br />SPRINKLER / SUPPRESSION SYSTEM <br />Number of Heads <br />Other: <br />I hereby codify that 1 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 or the performance of construction. That I am authorized by the owner of this property <br />to perform t kn7nitl5-513p1fEatic.'ris�.� a and I comply with the State Contractors Law 18.27 RCW and 296.200 WAC <br />\�J /�^ to /� 4�01/ I <br />OwnerlAutho i goof 6lgnaturo <br />ate (Revised 2/2011) <br />