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PERMIT APPLICATION <br /> BUILDING/MECHANICALIPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 www.everetlwa.org <br /> SITEAf IRESS: PROPERNTA%It P[R ITp <br /> � W � — <br /> LEGAL lor new wnsWction�. Snort PlaUsubtlivision Lot No._ (attach wpy ol lonp legal descnDlion) <br /> OWNER r� �/JAT � Phonc/E�mail <br /> Atltliess 1� CdylState/Zip � <br /> APPUCANT; Oxner OHnefsA9eol Coniraticr _Conlraclor'sA9en� _Tenant�mwip�o.eeamrvmw,semi:vm�eo..ai�oo.an:n:^.e.,ace) <br /> CONTRACTOR .� � �t„�M (�C State Lic.8 RCEpP C. N7. Ciry dus. Lic.#�$3 S <br /> Address �O Qnx Z 7 Jf�b �1.. � Z9 Phonc/Email /{fp ^ (p �� 2- I <br /> TENANT BUSINE55 NAME CONTACT FOR PERMIT <br /> PhonNE-mail <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> 6zisUng Use of Owla�ng H[AT SOURCE: <br /> Pioposed Use o�Ou��:ding _, Gas E�ediic_ OtYcr <br /> Buildmg lype k Singlc Famny _Duplew_Townhouse _Multi�FamAy _,Commeraal <br /> T� e of wecL ., New _ Atldilion ,. Remodel _ , R" ePair.__ T I Siqn ,__ Spimkler Demo'dion Chan e of Usr. <br /> DES C RIPTION OF W ORK(addn�onal space pro��dca on Urc eacw)- <br /> �NSi4tL gF1GL� �AAT�_ V�1WE <br /> �w ��4vmv.+it �Lonz <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> TypcolProjecl: _New_ Addn _Allcralion_Nepair TypcofProjCCC ,_New_Addn _Allcralion_Repair <br /> ShowNumbcr N olfixmms ShowNumbcr N�o/lixfurCs <br /> NC—air handlin unils Toilrl <br /> I=orced air s stems F3aIMub <br /> Gas i in � Lavato wash basin <br /> Watcr healcr Showcr <br /> Gas fre lace Kdchen sink 8 dis osal <br /> Gas ran c U�shwasher <br /> Clolhr.5 d cr Clothes washer <br /> Ran C hood Wairr heatcr <br /> Erhausl fan Smk scrvicclbadmo letc. <br /> Ileat um � l3ackliow rr.venfer <br /> Umt�calcr Uiinal <br /> Roiler Drinkin I'ounlain <br /> Rclri cral.�n Floordrain <br /> Noodslove Grease Ira <br /> IJudm ftoot drains <br /> Olhcr Medical Gas <br /> SPRINKLER /SUPPRESSION SYSTEM o�i�cr: <br /> Numbcr ol Hcads Other. <br /> I heie�y mNty IPaI I liave rea0 and r�amnea Ui5 appiira�qn and Anow i�e same lo be Inie anA mnetl.NI provrsMms ol l:m,antl oN�nxnces qovemin9lnls lypa ol woik wii Lc mnpi <br /> wA�wnrinrr sprcAma nrrein or nol ihe 9ianl:ny ol a pc�mil�acs no�prr.sumu l0 9rve aui�only lo violdln or 4�Mel I�rt pmvlslon ol nny o�nr�slatn ar loul law�eguUiinq mnslmcuon <br /> Thal I�m auNotlrM AY��^onnn ol Ihrs properry to p^do�m L•in wmk lor whitl�apD��F��ion Is made anA I rnmON"^����^Slaln Conlnclors Law 18.77 Nf,W ana 79B 700A WAC <br /> � NCviscd 90014) <br /> Owner/Aulhorired Agent Signature U�Ic � <br />