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P�RMIT APPLICATION <br /> BUILDINGIMECHANICAL/PLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3Z00 Cedar St., Everett, WA 98201 425-257-8810 FAX 425-257-8857 vnrnv.evereriwa.org <br /> SITE ADDRESS: PHOPERTY TAIt q PEAMIT S /-y� <br /> 1 � �") I �S.f" � — W� <br /> LeGA l for new construction: Short PlaVsubarv�sion Let No_ (anach eopy of lon�tegal Gescnplion) <br /> OWNER / , ����fe� )�� P�oneJE-mail a � �S � � <br /> nddress Cityl5latc/Zip <br /> PPPLICANT: Owner _Owners�9ent Conlractcr Con:nc�o(s�geN Tananlp��eipnNaee:ar.e.mc�ree.,:�cmaoo.m�me��o��,:�e�w�i <br /> CONTRACTGR /y UL✓� F" ��^�"� h'�' State Lic.#MDC/�(I +'��6 3 J U City Ous. Lic. p 05 3�0 3 S <br /> Addr��ss �75� 5 yl �SF Sr Siu� Jn��S�. W � �7�Z�tU honc/Ema � }bu p I <br /> Cr� N�.ai�/�v-i/J r w t a•w� <br /> T�?NANT BUSINESS NAME CONTACT FOR PERMIT <br /> PnonelE-mail <br /> 'BUIE.DING PERMIT APPL�CATION CONTRACT PRICE OF WORK <br /> Existing Use of Building HEAT SOURCE: <br /> Propr,sed Use of Duilding Gas_ Electnc_ Othar_ <br /> Building type. _Single Family _Duplea_Townhouse _Mulli•Family _Commercial <br />� Type otpro�r.cr New Addition Remodcl _ Repair T.I. Sign Spnnkler__Demolition___Change of Use <br /> DESCRIPTION OF WORK lada�ilcnal space p�ovidea on rne oar.k)� <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Typo of ProJoet: _Now_Addn _,A�teiatlon_Ropalr Typa of ProJecC _New_Addn _Altoratlon_Ropalr <br /> Show NumDcr(N)ol(xlum: Show Numbor/N)ol flxturns <br /> A/C--air handlin units I Toilel <br /> Forcetl air s stems Bathlub <br /> Gas piping � Lavatory(wash basin) <br /> � Walen c�aler Shower <br /> Gas firc lacc i Kitchen sink&disposal <br /> Gas !ange �ishwasher <br /> Clolhes dryer Clothe5 washer <br /> Range hood Watei heater <br /> Exhaust lan Sink(service/badmop/etc) <br /> Heal pump Backflow preventer <br /> Unit hcaler Unnal <br /> 8atler Drinking Founlain <br /> Refrigeration Floor drain <br /> Woodstove I Grease tra <br /> Duclmg Roof drains <br /> Other Mediwl Gas <br /> SPRINKLER / SUPFRESSION SYSTEM otner <br /> Number of Heads � O�her <br /> I�creGY�tiN U'���havo matl nnC emmnM It+is oppllrntion onC knav l�e samo to Ea Wo nnd mrted.AD provWcns cl I:ms ond orCmnnces Oaveminp I�u fype ol woA w.Y be mmp(:ed <br /> wC�vTclher spml�ee nertln ar not.iTe grwting ol n perm�t tloee not prosume to gNo owwr�y to vnqto a cdnco�17ie pmvislon af any mJier state ar Urei lav re9uisvg wnfwcwn <br /> Thal I um auNonzM by No annef o1Nls piopofty lo poAo�m Iho work fot wlilUi uppliciilLui k ma0a and 1 compry wl:ti No$�e!e Cmtranors Law 10.27 RCW anE 74G.200A WAC <br /> ��"�� � � �� �� S �I <br /> OwnorlAulhoriznd Agont Slgnaluro Date (reviseeY1013J <br />