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PERMIT APPLICATION <br /> BUILDINGIMECHANICALIPLUMBING/SIGNISPRINKLERIDEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810-FAX 425-257-8857-www.everetlwa.org t1 �V�,1 <br /> APPLICATIDNS ARE ACCEPTED FROM 8 AM TO 4 PM ��p U I ��/�/ `'� <br /> SITEADORESS: �� ��� � PROPERN;A%p( �� ,^ RMITp <br /> � � i V <br /> LEGAL�or new construction: Short PlaVsubdivision Lot No._ (atlach copy ol long legal Oesuip�lon) <br /> OWNER � � �j ' '1 Z � one/E�mail Z ' � ��J <br /> Address' �� �\ - LitylState2ip / � � �` <br /> CONTRACTOR , 1 ? �� �� L 81 lie.# � U I � � <br /> Adtlmss �.3 �I ' �'� ' ✓ / PhonMEmail n <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT^ '�r� ���/SG' <br /> y' �1 ;I!1 C�L ,7] �. <br /> ` � rj� T� I �� ��lrl� Phone�E-mail � JZ� ,�\ <br /> BUILDINGPERMITAPPLICATION cONTaaCiPRICEOFWORK ��� <br /> � HEATSOURCE: <br /> Caisling Use of Building �`�LT��-- S jt-R��p <br /> ProposedUseofDuilding �����- S m�`-�— Gas eieanc_ omer_ <br /> Buiiding type: _Single Family _Duplex_Townhouse _Multi-Family �Commetcial <br /> Type of projecl: _New�Addi�ion _Remodel _Repair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Destriytion of Work(addiflonal space provided on fhe back): n 1� �� 7 ��f,(� r /���� �� <br /> (\ v i� r ( L /T _/NTf"I��UZ <br /> I��c� � W�lI�S ��( 1577/�CT �) I.iIL�/NC; <br /> Nave you slarted working without a permft4 _YES _NO `- {, �,,- `; 'l �/ �� <br /> MECHAMICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typeo(ProJecl: _New_Addn _Alleratlon_Repalr TypeofProJect: _New_Atltln _Alteratlon_Repalr <br /> Show Num6er(#)ol llKfwes Show Num6er(KJ ol l/atures <br /> � A/C—airhandlingunits Toilel <br /> � Forced air s stems BathWb <br /> � Gas pipin Lavato (wash basin) <br /> � Water heater � Shower <br /> Gas lireplace Kilchen sink 8 disposal <br /> Gas ran e Dishwasher � <br /> Clothes d er � Clolhes washer <br /> Ran e hood � Water heater <br /> Exhaust fan Sink(service/barlmo letc.) <br /> Heat pump � ''ackflow preventer <br /> Unit healcr �'inal <br /> Doiler .rinking Fountain <br /> Refri eration � Floor drain <br /> Woodstove Grease Ira <br /> � Ductin Roof drains <br /> � Other Medical Gas <br /> SPRINKLEP2 l SUPPRESSION SYSTEM I Other: <br /> Number of Heads ( Other: <br /> I hereCy certify that I have r=ad and e:amined this ap;!!c.:;6.n ana know the same lo be Irue ana corred.A�I provisions ol laws ana ortlmances goveming <br /> this type of work will be complieC vrlh whether specified herein or nol.The grantirg ol a permil tloes nol presume to give authority to vioiafe or wncel <br /> the provisi ol an other�btata or lowl la ulating construction or the pedortnance ol constmction.Tt�at I am authorized by the awner ol Ihis pmperty <br /> to peAor th�vro foI ich appli af is ade anC I comply with Ihe State Contractors Law 1827 RCW and 286200 WAC <br /> � ! �' �'' �/{R�.lz <br /> Ownc utfibdze ge t Sign t e Dale (Revised 1/201f) <br /> 1 <br /> f � <br />