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� <br />� <br />PERM�T APpLICAi`ION <br />BUiI�DING/MECHANICALlPLUMBINGISlGNISPRINKLEF2/DEMOLfTION <br />CITY O� EVER�TT P�RMIT SERVICES <br />3200 Cedar St., Everett, WA 98201 425-257-8510 FAX 425-257-8857 www.everettwa.org <br />�� � Q � <br />fo� ncw corlst�'uction: Short PlaUsubdlvisio <br />�R <br />ess ` <br />LICANT: _ Owner <br />� a- a.{� v i b ��iE-�,a�i <br />�--�"' CitylSt&t?JZIp <br />Owner'S Aganl C�ntr�ctor _ Cpntfaclor's A��nt <br />ri-�-'� State Lic # � <br />I-�' � I-t.. � 61 <br />CONTACT F <br />BUILDING PERMIT APPLICATION <br />�xisiing USe of 8uilding <br />Proposed Use of Buil � �2 <br />BUllding type; _ Singla F�rnily � Dupfex�Towhhouse � Mult�i-� il� <br />T e of ro�ect: New Additioiz Remodel Re air liT.l. <br />D�5 R{PT'I0�11 OF WpRK (�dditronel spacs provide on ths backJ : <br />C�.� � c��- ��i �� ct.s <br />� � <br />MECHANICAL PERMIT q,ppLICATION <br />ofProject: �NAw_Addn ,�Akeration_ReValr <br />SHow Numb�l' !i of frxh�rps <br />NC — air h��dlin units <br />Forcad air s stems <br />Gas i in <br />Water heater <br />__ Gas fire�lace <br />t�0nge hood <br />Exhaust fan <br />Heat pump <br />U�it heater <br />BolEer <br />Ref�iqarati on <br />Oiher <br />SPRINKL�R / SUPPRE33lON SYSTEM <br />.�_ _ Number af He�d6 <br /># <br /># <br />No, (attach copy of long legal tlescription} <br />0 <br />�enent (mu24 provide a I¢tter of COnP,Pflt fiom ihe avm¢r Ip ao v�ork In (ha epace) <br />! ihi c�ty eUs. L��. # Qa t� a o <br />�one/Emeil �b . a � g - � �� <br />P�RMIT M �'1r1 i < �.�V�.a-+r1 <br />L 1J1.1 YYl i-C. 4l> <br />PRIC� OF WORK <br />� Corrilnercial <br />r rvz c�, <br />P�UMBING PERMIT A <br />pf Use <br />7�ON <br />vf ProJect: _New _Addn _Alterat�on �Repair <br />__ Show Number (#) of Nxturea <br />- � Toilet �.�...�s_ <br />Shower <br />Kitchen <br />Clothes waSh <br />WaZer hea2er <br />�sckflow �revent� <br />Urinal <br />Drinking Founfain <br />Floor clrain <br />Roof dr�ins <br />Medioal Gas <br />Other� <br />Other: <br />I hereBy ccrtiy lhat I heve raatl antl exsmined th�s eDDlication and know the gemc to bs true end correct AU Droviaions of Iews ana ortllnances goveming thls iype ot wom wpl be comp <br />� whetnar specrfi�d hsrein or not. 7he granfing of a pormit does not presume to gNe authpri(y to violata or �,ncsl the provision of eny olher ste0e or loce) iaw .egulaGng construction <br />The I em a�thonzed by t1�s own r of thls property co perForm ihe rrork for w ch eppll atfon le mstle and � camply With �fie State Contractors Law 18,27 RCW and 296,200A WAC, <br />nerlAuthonzed � � � � � <br />qgcr►t 3ignature p�tg <br />(Rev;sed 9/201a) <br />