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0�!2612a12 08:28 2065757529 STATE MECHANIC� P�GE 02/62 <br />� <br />PERMtT APPLICATION <br />BU1LDiNGlMECHA�itCAL/PLUMBIIVG1St�N/SF'RINKLER/DEMOLlTION <br />CITX OF E1/ERETT PERM1'T SERVI�ES <br />3200 Cedar St., �verett, WA 98201 - 425-257-8810 — FAX 4�5-257-8857 — www.ev�rettwa.org <br />���` '` ',.��.,' `c ` �-APPLICA710NS ARE ACCEPTED FROM 8 AM TO 4 PM <br />TE ARE?RE�S; �f'��-'_==�l�l�.��4�_`��: P�a L Ie�T�#� ' I �� �I '� Z) �i –CJi��� <br />for new CotlSifllCtfO�: Short PlaVsubdiviaion <br />,cTo�t ��'� iYlGc N � <br />$ `10�v .S �-2.� �v a <br />,/Yl�� �s�c cc, c ;� c.-C')v" � <br />BUILDIIYG PERM�T APPLlCATfON <br />NO, (ettach copy of long IGgal deec�iption) <br />L L 8� I Lio. # S T�dr1 � <br />�-t 16(,�1 PhonelEmall �(�?,r�-%� ��`� Y��ti�J►u-1c� <br />ON T FOi2 PERMIT ��y p(/ L O�'�(�lYl�} <br />��„�rE�,a,� ?�%� W�'7v�- � �..r � ^7 bvrJ�st��k.r�xl�,►� <br />CONTRACT PRICE OF WOI� f�i��a <br />�xisting Use of 8uilding HEAT 50URC�: <br />Proposed Use of 6uilding Gas__�__ Electric_ ather <br />�uildi�g type: _,,,, S+ragle F��iay _ Duplex _Townhcz+-+sa ,____ aUludti-Farr��ay X Co�'+raiercia! — <br />Type of p�oject: `� New ,_ Addition „ Remociel _ Repair _ T,I, � 5ign �3prinkier _Demolition�Change of Use <br />description of Work (aaditionel spaae prov/dcd on the back) : <br />Have you Started worktng without a permit? �Y�S _Np <br />MECHAI�ICAL P�RMIT APPLICATION <br />7ype of Prajeck: _New_Atldn _Aketadoo^Repair <br />Show Number (�f) of frxtures <br />; A/C – air handlina units <br />Gas piping <br />Water heater <br />Gas far <br />CEoth�s <br />j Ofher <br />SPRINK�ER � su <br />f�1U171bb� Uf <br />PLUMBING PERMIT APPLIGATION <br />aPProJect: _,,,_New,_Addn _Alterecion_Repair <br />Show Number (#) of Ti�cfures <br />Ki�then slnK & d�s <br />Dishwasher <br />Glothes tivasheP <br />Water heater <br />Sink (service/bar/ <br />Backflow preventf <br />Urinal <br />Dfinkin� Pountain <br />Floor drPin <br />Graae� trap <br />Roof drains <br />Medica! Gas <br />Q#Ne�: <br />1 hereby certify that 1 haue read end sxamined B1iS BpptlCAtion and kltow ihe same io be Lue an� �rr�t. AE� provisiotza of lsws and nrdinances gaveming <br />th)e rype of v,rork �Jill bo complicd with whcther specified here�n or not. The grenting af a permit does noF presume to give auYhority to violaSe or cane�l <br />the provision af any other state or local raw regutat�ng consSr�ction or the performance of construdion, Thet I am authorized py tha ownar of thie prnperty <br />to peffolYn �r whiph a ' tion s made end l comply with t State Cont ors Law 18.27 RCW ai�A Z96.Z00 WAG <br />w ".��-- � 2 � /� <br />OwnedAuchorPzetlAganf 8{ nature Date (f�avlsed 2l20y1) <br />