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�ERMIT A�PLICATI� <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EV°RETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> SITEADORESS: I � O Q PROPERTYTAXN P RMITO <br /> 5 �� <br /> LEGAL tor new construclion: Sho�PlaUsuDtlivision Lol No._ (altech copy ol long legal descriplion) <br /> OWNER IN �,, Pho�elE•mail <br /> Atldress � 2 � CilylSlalef2ip A �Z�(� <br /> APPLICANT:_Owner _,Owner'sAgent _CoNractor ,_ConlractaYsAgenl _Tenanllmu.�prodaaoiene�oiconsomr�oTiroo.nerioaowoMnu,e.v�l <br /> CONTRACTOR �6��5 t/W1 bl S�ate Lic.# z! I ' City Bus. Lic. N <br /> Adtlress � P�onelEmail �2,� Z ? <br /> O CT F R � ` ��.� <br /> �,�',, n \/"� <br /> PhonelE-mail (J(7�Y�G - <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 7s1� <br /> Existing Use ol Buildin9 SX S��f»A - HEAT SOURCE: � <br /> Proposed Use of Building Gas_ Electric_ Other_ <br /> Building type: �gle Family _Duplex_Townhous _Multi•Family _Commercial <br /> Type of projtct: New Addition _Remodel Repair T.I._Sign Sprinkler Demolition Chan e of Use <br /> DESCRIPTION OF WORK(additional space pmvided on�he oack); <br /> � �j.LuFC/ �/G�,�NQ l�n/ Cfb-�✓ ` ��j9,$Nu¢YT} <br /> ECHANICAL PERMI A LIC TION PL BI PE MI PP 1 A ION <br /> TypeolProJeel: _New_Addn _Alteration_Repair � Typeo(Project: _New_Addn _Alteration_Repafr <br /> Show Number(M)o/(.�'tures Show Numbcr(N)o/�xtures <br /> AIC—air handling units Toilet <br /> Forced air systems BathtuD <br /> Gas piping Lavalory(wash basin) <br /> Waler heater Shower <br /> Gas firepiace Kitchen,ink&disposal <br /> Gas range Dishwasher <br /> Clothes dryer Clothes washer <br /> Range hood Water heater <br /> Exhaust lan Sink (service/barlmopletc.) <br /> Heat pump Backllow preventer(inside bltlg) <br /> Unit heater Urinal <br /> Dotler �rinking Founlain <br /> Reh�geralion � Floor drain <br /> Woodstove Grease Irap <br /> Ducling Roof tlrams <br /> Other Medical Gas <br /> SPRINKLER I SUPPRESSION SYSTEM O�her. <br /> Number of Heads Other: <br /> I I�ere6y cerlily I�al I�ave�enE ar.d examined Uis appliwtan an0 know I�e same lo Ee Ime and couecl All p�avisions ot laws nntl o�A��ences goveming Ims tryc o�work wll Oe comDl:ed <br /> v.i�h w0cl�er spenfed�eicin oi not T. ..niing ol a perm�t Coes nol presume lo gNe aol�only lo vroiale oi wncCl l�e piovision ol anY ot�er s1ale or local law regulqling conslmclion <br /> TAa ' orieetl Ey Ihe owner ol l�piopetly lo pedorm I�e Nroik lor w��ch appl¢alion is made�nE I mmply wilA I�e Sinto Conlrxton Law 1827 RCW and 296 200F WAC. <br /> ����.. ����� <br /> wnerlAuthorizodAgu Ignature ale (Revised4R015J <br />