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Feb, 21, 2014 12,45PM <br />� <br />� <br />No, 3947 P, 2 <br />PERMIT APPLICATION <br />BUILDING/MECHANICAL/PLUMBIIVG/SIGNISPRINKLEI�/DEIWOLITION <br />CITY OF EVERETT PERMIT S�RVIC�S <br />3200 Cedar St., Everett, WA 98201 - 425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTEp FROM 9 Ann Tp a Pnn <br />� <br />PERMIT <br />LEGAL for new consiruction: Short PlaUsubdivlsion L0I No. (�ltaCh COAY Of long 1e991 de.crip�ipn) <br />PhanelE-mail S b(J � "� 1,,� � <br />CI Iy1S t3 felZip <br />L&ILiC.# <br />BUILDING PERMIT APPLICATION <br />Pnone/Email "� (/, � Gl � ' `1KU <br />R PERINIT r1n_�_ �� -��.j�� <br />t!1'•• <br />r/L!►{'iI�1 � <br />• .; <br />Existing llse of 6uilding �sM� HEAT SOURCE: <br />PrppoSed UseOf Buliding�:/%��� Gas_ Electric Other_ <br />Bullding type: � Single Famlly _ Duplex _Townhouse _ Mulli-Fami{y „ Commercial <br />Typg pf projeCl: _ New _Additlon _ Remodel �[ Rep2ir _ T.I _ S�yn _Sprinkler _Demolition_Change of Use <br />DeSCripUOn of Work (addltlonalsAaceprovldednnthe backJ ����� LO� �� �INd_� � („ , � #U` �, „� � <br />'[( li b-�'irt �! l�[ f�i <br />_ , �t P��P <br />Have you Sta+ted working without a permit? _YES �NO <br />MECHANICAL PERMIT APPLICATION <br />ofProject: _Naw_Addn _Alteratiort�Repair <br />Show lVumber (#) ot flxrures <br />� A/C — alr handling units <br />Forced air s stems <br />Gas pipin� <br />� Water heater <br />Gas Flreplace <br />I Gas ranae <br />Range hood <br />�xhaust Fan <br />Unit h <br />Boiler <br />SPRINKLER / SUPP <br />ber oF Heads <br />EM <br />PLUMBING PERMIT APPLICATIUN <br />Typa of Project: _New_Addn WAlterat�on,�Repair <br />Show Number (�) of fxture5 <br />� Toilet <br />� 6athlub <br />Shower <br />Kitchen sink & d <br />Dlshwasher <br />Clothes wast�er <br />Water heater <br />Sink (service/ba <br />Drinking Fc <br />Floor drain <br />Grease tra <br />Med�C31 Gas <br />O ther: <br />Othar: <br />I hereby certlfy thal I have read and examined thig ;�ppllCatlon and knoW lhe 58me t0 be Irue and correct. All provisions of laws and ordinances governing <br />this type of work will be complied with whelher spscified herein or nol. Tha granling o! a permit does nol presume [o glve authorlly to vlolale or cancel <br />Ihe rOvISIOn Of any other gl5te a� IOc91 law re9U�aUng COnStrUctlon or �h2 perfOrmance of construction. That I am authorized by lhe owner of Ihis property <br />�o pe or tne - rk r wnich applica�ion is made and � compty wilh lno S�aie Con�raclors Law 16.27 RCW and 296.200 wAC <br />�� � <br />0 ner/Autho ctlAgent �flnalurc Dale (RevI3eA2/2091) <br />