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� i <br /> PERMIT APPLICATION ! <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Ev�:rett,WA 98201 -425-257-8810— FAX 425-257-8857—wvwv.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM <br /> ` j9G�N C✓E�GlIEL�✓ �✓F PROPE����p7UU4Ue��UG' �RMITA — _ <br /> r. <br /> LEGAL lor new conslruction: Short PlaUsubdivision Lol No._ (atlach wpy of lorg legal tlesaiption) <br /> OWNER G���'� ��SH�t��l✓Ll= Phone/E•mall 4Zf y1��8��� <br /> Address 5,oy C✓E"4itcr,✓ e�� CitylSlale2ip F✓C���r1 ��` �/SL�3 <br /> CONTRA�TOR I�N�tI S/�n� C011 • . �ai���.n �✓��/0 Ct'fli�'� <br /> Address /ZJ� u��,I'�T(�� ��r�' �" ' ��'/ (�l` ��lv� Phane/Ema1 jl'� i�L-o1eG . <br /> TENANT BUSINESS NAME p�.6�J�53I�'. CONTACT FOR PERMIT f�C�/� ��J�/,���/ <br /> 6�'���� //v}1,�/�.�/y`� Phone/E-mail ✓L'ZC✓17 /l�'I I J � , . (L�h <br /> BUILDiNG PERA7IT APPLiCAT10N CONTRACT PRICE OF WORK S O �-� <br /> Existing Use of Building_. HEAT SOURCE: <br /> P�oposed Use of Building Gas Eleaiic_ Other <br /> Building lype: _Single Family _Duplex_Townhouse _Multi-Family _Commerc�a� <br /> Type at proJect: _New _Addltion _,Remodel _Repalr_T.I.�Sign_Sprinkler_Demolition_Change of Use <br /> Descnplion of Work(atldrlionel space provided e Iba back1: <br /> f N'i%�c c,�i c,lrcf. srsr� Ch3i��(f <br /> Have you started�Nork;�g wi:hout a permit7 _YES �NO <br /> MECHANIGAL PERMIT APPLIGATION PLl7MBING P�RMIT APPLICATION <br /> Type of Projoct: ,_Nuw_Addn _Alteratlon_Rapair Typa ol ProJect: _Naw_Addn _Alteration_Repair <br /> Show Number(N)of fixtures Show Number(N)oI�xtures <br /> AIC—air handling units Toilet <br /> Forcedairsystems _ Bathlub <br /> � Gas piping Lavatory(w25h basin) <br /> Water;�.=ater _ Shower <br /> Gas freplace Kitchen sink 8 disposal <br /> Gas ran e _ Dishwasher <br /> Clothes dryer _ Ciothes washer <br /> Range hood Water heater <br /> Exhaust(an _ Sink(service/badmop/e1cJ <br /> Heat pump BackOow reventer <br /> Unil healer _ Unnal <br /> Boiler _ Drinking Fountain <br /> Refri eretion Floordrain <br /> Woodstove Grease irap <br /> Ductin3 Roof drainG <br /> Olher _ 1Aedicai Gas <br /> SPZ!'!�KLER / SUPPRESSION SYSTEM _ Other <br /> Number ol Heads -- <br /> I hereoy certify;hat I have reatl antl examined Ihis application and krtow tha same to Lz true and corcecl All provisions of laws ond ordinances Qoveming <br /> U�is�ype ol woiK I be �mplied,xilh whether spocifed herein or nol.The granling ol a portnit does nol presume lo yive authorily to violate or cancel <br /> Ine piovision of y olh r slate or local law regulating wnstmction or lhe peAortnance ol coes`mction.That I am authonzed by lhe awner of this propetly <br /> to pedorm Ihe w:�o rhia�application is made and I comply wilh the State Gontractors Law 1327 RCW and 2�6.200 WAC <br /> ;-25-// <br /> OwnerlAutho zed :nt Signaturo <br /> Date (Revised 7?l20f0) <br /> . 1l� <br />