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� PERMIT APPLICATION � <br />BUILDING CHANICAL / PLUMBING / SIGN / S NKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FAX 425-257-8857 �(E) everelteps@everettwa.gov � www everettwa govlpermits <br />PROJECT S{TE INFORMATION <br />PROJECT 51TE ADDRESS: � eJ OZ IC!'* JNI EQ �V� PROPERTY TAX #: Db'T 3� � S-��I O� <br />LEGAL for new construction: Short PlaUsubdivision �___...._,..,,,,�„�_,__„_�„�„_,,_„_Lot No (atlach copy of long legal description) <br />� BUILDING PERMiT APPLICATION _ __ _J <br />Existing Use of Building: ' ' Contract Price of Work; �,_ Ct, ls'T/, v�._,., � <br />—� <br />Proposed Use of Building: �� Heat Source: �Gas ❑Electric ❑C�iher_ <br />Buildin Typc ❑SFR-Detached ❑SFR-Atfached ❑Dupi�x ❑Multi-Family-t6 of Units � ❑Commercial <br />Typ� of Prc�ject ❑New ❑Addition �emodel Cif�epair ❑T I� C1Si�n ❑S�rfnkler ❑Demolition ❑Chan� <br />DESCRIPTION OF WORK: <br />l�.iu" �W'� C9'►�p���!'1 °� V�Q.diGtG¢ 1��` C�'B"�� fiBr�. <br />r / <br />AS5CJCIATED BUILDING PERMIT # (if a <br />MECHANICAL PERMIT APPLICATION <br />Type of Project: _New _ Addn Alteration Repair <br />Fixtures Lisf of Fixtures Fixfures List of Fixtures <br />A/C - Air Handling Units Heat Pump <br />Forced Air Systems Unit Heater <br />�as Pipmg Boiler <br />Water Heater Refri eration <br />Gas Flreplac� Wood Stove <br />Gas Range Ducting <br />Clothes D er Hookups Other: <br />Range Hood <br />Exhaust Fan <br />SPRINKLER I SUPPRESSION SYSTEM <br />Number of Heads <br />❑Industrial <br />of Use <br />PLUMBtNG PERMIT APPLICATION <br />Type of Project: New Addn _Alteration _Repair <br /># of List of Fixtu�es # of List of Fixtu�es <br />Fixtures Fiztures <br />Toilet Backflow Preventer (Inside Bldg) <br />Bathtub Urinal <br />Lavatorv (Wash Basin) Drinking Fountain <br />Shower Floor Drain <br />Kitchen Sink 8� Disposal Grease Trap <br />Dishwasher Roof Drains <br />Clothes Washer Medical Gas <br />Water Heater Other: <br />Sink (ServicelBaNMop/etc.) Other: <br />ACKNOWLEDGEMENT I have reviewed this appllcaiion and con(irm the information contained herein is hue and coriect. Work done pursuanf lo this permit must comply with <br />current /ederai, stafe. and local law. 7he granting o/ a permif only authorizes approved work and no deviafions therefrom Devrations musf lirst he aufhorrzed in writing from the <br />�uildrng Oificial before being authorized under any ciicumstance / am the owner, or I am authorized by the owner of this prope�fy lo perform fhe work /or which applicalron is made <br />and I com�iv wdh the Sfafe Contraclois Law 18 27 RCW and 296 200A WAC <br />Ce�-,-u:�- <br />wne IAuthorized Agent Signature <br />�� <br />Gty o� Everett Olficial Use Unly <br />PERMIT # <br />20�� �i(a0�—fl�;, <br />� (Rel'iSHCi JO/1�:.`U751 <br />