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i <br /> . � t <br /> PERMIT APPLICAT:JI� <br /> BUILDING/MECHANICAL/PLUMBINGISIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 -425-257-8810—FAX 425-257-8857—www.everettwa.org <br /> APPLICATIONS ARE ACCEPTED FROM E AM TO 4 PM <br /> SITEADDRESS: /U// PROPERNTAII• PERMITi _ <br /> � A S �. pD � ovsv <br /> LEC'sAL lor new construction: Short PlaVsubdivision Lot No._ (attach copy of lon9 lepal tlesalptim) <br /> OWNER 7� c.l �1✓Gn..S Phona/E•mail <br /> naa�55 1 N I 1 U�.I�e.s Hi� �12ru� o�a�n��a A g 8 <br /> CONTRACTOR y� L&I Lic.# R, <br /> Address —� SO � ` PhonelEmail � ' — � <br /> TENANT BUSINESS NAME CONTACT FOR PERMIT u 1S 7�rr�t�'UCSp�� <br /> PhonelE-mail � -�' �3 . <br /> BUILDING PERMIT APPLICATION coNrw+cr PRICE oF woRK <br /> Existing Use of Building �mG ._ HEAT SOURCE: <br /> Proposed Use of Building Gas Eiectric ONer <br /> Buildinqtypa: _SingleFamily _Dup�ez_Townhouse Mu�ti•Family _Commerciai <br /> Type of project: _New _Addition _Remodel _ epair_T.I._Sign_Sprinkler_Demolition_Change of Use <br /> Description of Work(addifional space provitled on fhe backJ: <br /> Havc you started working without a pertnit� _YES � <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypeofProJect: _New_Addn _Alterotion_Repair TypeolProJect: _New_Addn _Altemtion_ epelr <br /> Show Number(It)o/fixtures Show Number(A' of fixtures <br /> AIC—airhandlin unils Toilet <br /> Forced air s slems Bathtub <br /> Gas pipin Lavato (wash basin) <br /> Water heater Shower <br /> � Gas fireplace IGichen sink&dis osal <br /> � Gas ran e � Dishwasher <br /> Clothes d er C'othas washer <br /> Ran e hood � Water heater <br /> Exhausl fan Sink(service/barlmo letc. <br /> Heat um Backflow reventer <br /> Unit healer Unnal <br /> Boiler Drinkin Fountain <br /> Refri eration Floor drain <br /> Woodsrove Grease trap <br /> Duclin Roof drains <br /> � Other Medical Gas <br /> SPRINKLER/ SUPPRESSION SYSTEM Other. <br /> � Number of Heads Other. <br /> I hereby certify lhat I have read and ezaminetl this applicaGon and know the same to L^lrue and correct WI provisions of laws and ordinances goveminp <br /> this rype of work will be wmplied v.ilh�.rether spedfietl herein or not The granting of a permit dces not presume lo give authonry to violete or wncH <br /> ihe provision ol any other state or local law regulaling consWction or the performance of consWdion.T�at I am auUorized by the ovmer of this propeity <br /> to pedorm lhe work for which application is matle and I comply with Ihe SWIe Contraclors Law 78.27 RCW aM 296.200 WAC <br /> ,�� � �/�/�// <br /> '�Cvner ut�odze gent 5lgneture Date (Revised7/t017) <br />