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PERMIT APPLICATION <br /> BUILDING*MECH�ANICAPLUMBING/SIGN/SPRINKLER/DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 Cedar St, Lverett, WA 98201 425-257-8810 FAX 425-257-8857 www.everettwa.org <br /> WE ADDRESS: 7e)!25Wgv(?000,3Q -2- 1 <br /> tyP�RTYYAXif PERVIrr <br /> 3c� f �-i b L <br /> LEGAL for new construction: Short Platfsubdmsion LotNo. (atfaoh mpy of lane legal desc7iption) <br /> tOWNER r Phone/Etnall S '3 ?70_I <br /> ddig38 0 6 S f S — c€iv/st EYE,- f� �-' o <br /> APK'l.ICANT:_Qtmer _Owner a AgerR XContr=or —f orrt< =fa Agt3nt _Tenant orw g oMea a tetter of�r� f om the Ovarcr m do uarn me mew} <br /> CONTRACTOR, klaMl,7 -[ v�I / ,, ��1s�t�ta 1_l� # f� ^� a eL;o. 00 <br /> Address l0 u6 Itv[tifa S td e 19} 1. 11fff i3OM qF0 Phone/Ernail (o f� � WQIt� l <br /> C0NT:7 FOR/PERMIT <br /> PhorwJE-rnall C <br /> BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK <br /> Edstfng Use of building _ HEAT SOURCE: <br /> Proposed Use of Building Gas EEealric other <br /> Building type: —Single Family _Duplex Townhouse _Multi-Fam€ly commarcial <br /> Type of pimlem i+i w Addition ReModel ReWir T.I. Sin S26nkler Demo€lgon Cliange of Use <br /> DESCW PTION OF WORK(adcft oat spare provided an the back): A-9 <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Type of Project _New;Addn �A{teratlon Repair Yype of Project NOW_/_A ldn Alteration_Repair <br /> Show Number off3xu,— 10. Show Number # of ffxwras <br /> AIC--air handling units i Toilet <br /> Forced air systems Bathtub <br /> ( Gas piping lave ,cash basin <br /> W®ter heater ; Shower <br /> Kttchan sink&disposal <br /> Gas rangeDishwasher <br /> ' Clothas dryer ; Clothes washer <br /> c <br /> RarMs hood 7 Water heater <br /> Exhaust fan Sink (service/bar/mop/etc—) <br /> Heat pumpBackflow preventer <br /> Unit heater Udnsl <br /> Boiler DrinMna Fountain <br /> I <br /> R2tgerabon i Fioordrain <br /> Woodstove 1 Grease M. <br /> -Ducting Roof drains <br /> r Other <br /> } Medica[Gas <br /> SPRINKLER I SUPPRESSION SYSTEM c1her <br /> Nvmbar of Heads 1 Otl}er. <br /> I hare@y oerdfy that I have rand and exemined this appucmwn and mow tho same to bB acre and cornua All PrOVWons Of kvrs and ordtnancwa govemog this lype Of wom vra be tamp; <br /> with vhsiher spenfiad herein or not The.g.wrthfig of a Permit noeS not PrasUmo to glue secondly to vloiete Or canCO M0 Pravtston Of any Other stale or low taw regulating con=cuu <br /> That 1 am aultl d by the Owner of this prapedyr to perform ttfe wortr forwh;cb apAkaWn to made and I coff"v4m the Stab cw"c2Ors tBw 18.27 RCW and 2B9YOOA WAC_ <br /> OwnerlAuthori Agemslgnmtura- Date <br /> (Ravrsed 8/2014) <br />