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PERMIT APPLICATIG�� <br /> BUILDI�vGIMECHANICAUPLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERElT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITEADDRES.�i� w/� A J� PROPERiYTA%11 P MIT,� <br /> {t <br /> LEGAI lor new consimction: Shon PlaVsubdivision Lot No._ (atlat�copy ol long legal descnption) <br /> OWNER ��Q�� � f � PhonelE-ma�l <br /> naares5 13 � 4 26�" CityiStalelZip �v W 8 Z� <br /> APPLICANT:_Owner _OwnefsAgent _Conlractor _CoNraclorsAgenl _Tenantn��s�wor.eekr.aci�senn�urmoc+,enoao�+on�n��aeD�-ei <br /> CONTRACTOR � /I S P m61 Sta�e Lic.q � 8 R' City �us. Lic.# <br /> ACdress�� lJp1( (�{?� �l`[',�oe� � PhoneiEma�l L� <br /> CON CTF RP R I <br /> �QnQ� I..bt,�'SC�`I <br /> FhanelE�mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 25�D <br /> Existing Use of Bwlding �K9i5�1n2, HEAT SOURCE' <br /> Proposed Use of 8 ilding Gas_ Eiectric_ Otner__ <br /> Building lype: _Singte Family _Duplex_ToK•nhouse _Mu�F(Fam�ly _Commerc�al <br /> Type of project�. New Addition Remodel Repair�T.L Sign__Spnnkler_Demohtron_Change ot Use <br /> DESCRIPTION OF WORK(adaarona!spacepnviaedon me eac�)' <br /> ���c� G�-�I-er ,r� Cvu,�(/1�s�f- <br /> MECHANICAL P MIT APPLICATION PLUMBIN PER IT APPLICATION <br /> TypeolProject: _Now_Addn _Altention_Repair Typeo}Projecl: _New_Addn _Alteration_Repair <br /> S�aw Number(M)ol firfures Show Number(M)o/�.rtures <br /> NC—air handGng units To�del <br /> Forcetl air systems E3athtub <br /> Gas pipmg Laratory(wash basin) <br /> Water heater Shower <br /> Gas fireplace Krtchen sink 8 disposal <br /> Gas range Dishwasher <br /> Clothes d er Clethes washer <br /> Rangc hood W�ter healer <br /> Exhaust fan Smk(scrvicc/badmop/elcJ <br /> liea�pump E3ackllow p�evenler(ins�dc bldg) <br /> Unn heatcr Ucnal <br /> �otler � Unnkmg Founiain <br /> Relrigcratiun Floor dram <br /> Woodstave Grease Irap <br /> Duchng Rcot drains � <br /> Othcr Medical Gas <br /> SPRINKLER / SUPPRESSION SYSTEM otner. <br /> Number of Heatls Other. <br /> I AveDy cetlAy I�al I have reaG and evamineE I�is appl:wUan an0 know I�e same lo Ce Irve antl cana�.All provis!ons ol Wws anUa�Gnancez gaveming iMs Iype ol wo�k wll Ee compl�eJ <br /> witq w�el�ri sOecR�eC�erein or not 1Te giamn9 a/a pmm�Ccrs nol presume lo grve au:homy Io vidate o�w^cel IAe proasion o'uny o:he�.late oi bcal law regulaun9 wnsbudron <br /> Tt+at e0 Ey i�c ownet ol I�Is piopeny to peAarm t�r Mo�k lor wA�t�applltalwn is matle and 1 ca�npy vnlh Ine Sleio Cerlmc'o�s Ww 1B 27 RCW ana 296 200A WAC. <br /> �� ����T <br /> rlAu orizcd geni5lgnature �e (RemsetlCR015) <br />