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PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES 2 _ o s-\1 <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 N\ il 1 OZ - Ui C) <br />ai t/e_ <br />PROPERTY TAX H <br />PERMIT # <br />- <br />LEGAL for new �:onstructlon: Short Plat//subeivislon_ Lot No._ (attach copy of long legal description) <br />OWNER 21 �V r��C_ 1/e %C- <br />PhonelE-mail L, '7 �2q�o-p <br />Address /i?6y <br />City/State/Zip <br />TOR/�,I,,dfi jer-1.4%41LO -/ <br />CONTRAC)� <br />Address L `1.2-/ Z�ertf, ' (O QD 2-5 Phone/Email y2 <br />_cam <br />TENANT BUSINESS NAME <br />l/"r �l/erCl ( (,,, (/rl �L <br />CONTACT FOR PERMIT Zb,? <br />Phone/E-mail �/e�j6 rN-�'d kle�M/C4l <br />BUILDING PERMIT APPLICATION <br />CONTRACT PRICE OF WORK <br />Existing Use of Building C// 'L HEAT SOURCE: <br />� <br />Proposed Use of Building C /,;i (G '/ Gas_ Electric Other_ <br />Building type: _ Single Family _ Duplex _Townhouse _ Multi -Family ,L Commercial <br />Sign _Sprinkler —Demolition—Change of Use <br />Type of project: _ New _ Addition _ Remodel _ Repair _T.I. _ /v <br />Description of Work (additional space provided on the back): ll ill -L /''to6/'4fc-4 „S rO,- 4466,r lLr7 X201"o&I <br />,Oe(- Willed AA175. / <br />Slave you started working without a permit? _YES �NO <br />MECHANICAL PERMIT APPLICATION <br />PLUMBING PERMIT APPLICATION <br />Typo of Project: _Now _Addn yAtteratlon _Repair <br />Show Number (4) of fixtures <br />Typo of Project: _Now _Addn _Alteration _Repair <br />Show Number (#) of fixtures <br />A/C - air handling units <br />Toilet <br />_ <br />Forced air systems <br />Bathtub <br />Gas piping <br />Lavatory (wash basin) <br />_ <br />Water healer <br />Shower <br />Gas fireplace <br />Kitchen sink 8 disposal <br />Gas range <br />Dishwasher <br />Clothes dryer <br />Clothes washer <br />_ <br />Range hood <br />Water heater <br />_ <br />Exhaust fan <br />Sink (service/barlmop)etc.) <br />Heat pump <br />8ackflow preventer <br />_ <br />_ <br />Unit heater <br />Urinal <br />Boiler <br />Drinking Fountain <br />R lod eralion <br />Floor drain <br />Woodstova <br />Grease trap <br />Ducting <br />Roof drains <br />_ I <br />Other <br />Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM <br />_ <br />I 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 gc.veming <br />this type of work will be compliewith 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 of 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 wJl I application Is made and I comp) wth the State Contractors Law 18.27 RCW and 296.200 WAC <br />OwnerfAuthorized Agent Signature Date (Revised 12/d010) <br />