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. . �� � i <br /> PERMIT APPLICATION <br /> BUILDING/MECHANICAL/PLUMBING/SIGN/SPRINKLER/nEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett,WA 98201 -425-257-8810–FAX 425-257-8857–vwvw•evereriwa.org _'/ . <br /> APpLICATI0N5 ARE ACCEPTED FROM 8 AM TO 4 PM " <br /> PROPER7Y TA%N PERMIT tl <br /> SITE ADDRESS:AD e , v� 8 U � <br /> �7 O <br /> LEGALfanewconslniction: SIwrtPlaVsubdivision <br /> Lot No._ (attach copy of long legal desuiplion) <br /> OWNER IJ n nS Phone/E-mail <br /> nanress qp$ M fa — c�ryrnac�a alasa.d h�A 8�0 <br /> cor+rnncroR � �8��10 # �' <br /> Address � SO i✓ ` PhonelEmail � - 2- .Z <br /> TENANT BUSINE55 NAME CONTACT FOR PERMIT L j j �ts�� <br /> Phonc/E-mail �(� –b �3y <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> �� HEAT SOURCE: <br /> Fxisting Use oi Building <br /> Proposed Use of Bwldin Gas Electric Other_ <br /> Building type: _ ingle Family _Duplex,_Townhouse Mulli•Family _Conimercial <br /> Type of projed: _New _Addition _Remodel _ epair_T.1._Sign_Sprinkler_Demolition_Change ot Use <br /> Desuiption of Work(udditional space providetl cn fhe back): <br /> Have you started working without a permit7 _YES _v NO <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typeof ProJect: _New_Addn _Alleratlon_Repair TypeofProject: _New_Adin _Alteralion epalr <br /> Snow Number(#)o/�xtures Show Mumber(it)o!flx[ures <br /> FVC-airhandlin units Toilet <br /> Forced air s slems Bathtub <br /> Gas i in Lavato (wash basin <br /> Water heater Shower <br /> � Gas fireplace Ktchen sink 8 dis osal <br /> Gas ran e Dishwasher <br /> Clolhes d er Clolhes washer <br /> Ran e hood I Water heater <br /> Exhausl tan Sink(servicelbarlmople[c. <br /> Heat um Backilow reventer <br /> Unit heater Urinal <br /> � Boiler Drinkin Fountain <br /> Retri eralion Floor drain <br /> Woodstove Grease trap <br /> Duclin I Roof drains <br /> Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other. <br /> � Number of Heads I Other. <br /> I hereby certi(y that I have read and examined this appiiwlion and know Ihe same to be true and cortecL All amvisions of laws and ordinances goveminp <br /> lhis rype of wnrk will be complied v.ilh whether spedfied herein or noL The granting ol a permit dces not presume to give authority to violale w eancel <br /> the provision ol any other state or local law repulaling conshuction or the performance ol consWction,That I am authorizetl by Me owner ot Mfs property <br /> to perfortn Ihe�wAc for which appliwlion is made and I comply with lhe SWte Contradors Law 18.27 RCW and 296.200 WAC <br /> � / (Revised 7/201!) <br /> 1 wnarlAulhodzed Agent ture Oate <br />