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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGN/SPRINKLERIDEMOLITION <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 �7 �3I'-/� <br /> SITEADDRE55: /�.��r PROPERTYTAX!! P M�T� <br /> � Z �(//O�`(I� DO Z O lIOA O - �� <br /> LEGAL for new construction: ShoA PlaVsubdivision LoI No._ (attach copy ol long legal descnption) <br /> OWNER 9�dH r9 PhonelE-mail � � T/ � � <br /> Address �j � �yv "// • V Y*�� Cily/SlatelZiP .vyv7/ f/ �/ <br /> APPUCANT: Owner OwnefsAgenl Conlractor CoNractofsAgenl _Tenant(m�+io•oraeaierc�aw�semo-ominaowr.ermao.�on�om�w+:el <br /> CONTRACTOR _« ��i�� %'k� � ��' � 'a' �� � �g���� � f� _ ' � '��<- ��� I COE Bus.Lic.# <br /> PhonelEmoil <br /> Ad.•' �ss <br /> TENANT BUSINEaS NAM� CONTACT FOR PERMIT� �y��y �vG� • <br /> �r.ao�► /�'Du�/ O�h''GA�i f�i'/l Ft-�NW'� / <br /> (�� �� Phone/E-mail D <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 0O <br /> Existing Use of Building u�J/ 4�'rf • HEAI"SGURCE: <br /> i <br /> �uy���Y / �N�V�� Gas � Eleciric� Other_ <br /> Proposed Use of Building �� — "— <br /> Building type: _Single family _Dupl x_Townhouse _Mulli-Family �Commercial <br /> T pe of pro'ect: New _Addition � Remodel Re�air_T.I. Sign Sprinkler Demolition_Chan e of Use <br /> DESCRIPTION OF W ORK(adddiona�soace provided on me back): `„G 5 ,}`,��y, <br /> /ht.ov�or ��ko✓�h'� � ��>v�dPi a�ce�,�iG�� . <br /> /aa�dvy �-rr��, pAN�j , �d tiy ceHdj f>'oKcq' �`a�9�i . <br /> MECHANICA6 PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypootProJocl: _Now_Adtln _Alleration_Repalr TypeofProJect: _New_Addn _Altoratlon_Repalr <br /> Show Num6er(x)ol Iixtures Show Num6er(M�o/lixfures <br /> A!C-air hanCGng units '� Toilet <br /> Forced air s stams �Balhtub <br /> j Gas piping I� l valory(wash basin) <br /> Wafer heater I Sh er <br /> Gas(ireplace I Kitch6n sink&disposal <br /> I �Gas ranae i Dishwd�her <br /> - � Clothes dryer j Ciothes sher <br /> Ran hood Water heat <br /> Exhaushtan � Sink(service�'badmopletcJ <br /> Heat pump � Backflow preverker <br />� Unit hea�er � Unnal A <br /> 6oiler I Drmking Fountain \ <br /> � Feff�geration <br /> � Floor drain � <br /> Woodstove ` Grease trap <br /> � Duding Roof drains <br /> � Other _ I'i Medical Gas <br /> SPRINKL�ER / 5UPPRESSION SYSTEM Other: <br /> Number of Hcads I Other. �, <br /> I hemb7 ceMy Iha�I have-eaC artl�.-amineG Ihis zpp�icatinn nnd Anow lhe same�o betme enA cortecl.All provis�.^.s ol�awa entl or0inanuf govaming thla lype of vmrk vnil Ee camplied <br /> v:nh w�e:bm specMrod hereln or ooL Tne 0����^9 0l e pennM dces nW Oresume to gNe aN�odty lo violate or cencel lhe provision ol any other atate or lasl lax repuiating,:onstrvdion <br /> Tnat I am aut�ori:ed 0 Ihe wmer of I�le pmperty to petlorm Ihe•mrK far whkN application Is maCe anG I u+'��-. HR�Ne Stete Comreclon Law 18.P7 RCW enC 296 200A WAC. <br /> �� � n %/� I, /J <br /> � v I <br /> Own rl u ho �ed/�g nt 918nature Date (ftevised620f2) <br /> \. <br />