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� � <br />PERMIT APPLICATI(�N <br />BUILDINGIMEGHANICALIPLUMB INGISIGNISPRINKLERIDEM�LITI4N <br />CIT1( 4F EVERETT PERMIT SERVICES <br />3?00 Cedar St.. Everett. WA, 9�201 �425-257-881� F,AX 425-257-8�57 4v�,ti^.^r.e�ei�ett�.va.org <br />APPLICATIQNS ARE ACCEPTEQ FRdP�I 8 Ah1 TD 4 PM <br />GAL for new construction: Short PlaUsubdivisio <br />s <br />PROPERTY TAX # PERMIT # <br />��i,��t� F�12 0 t�1�� �i �( I— IJC� <br />ot No. (attach copy of long legal description) <br />PhonelE-ma il <br />C /' <br />� )� I f'Q� 1 City/StatelZip <br />PPLICANT: __ avvner _ Qwner's Agerrt � Contractor <br />CONTRACTOR <br />Address � �% <br />Contractor's Ager�t <br />Tenant (musl prrnide a letter oT consent from the ownerto do wnrk in the space) <br />coE ��.,5. ���. � <br />�- ..,- Phone/Email ,[,` y �` ` L `L <br />CONTACT FQR PERPAIT <br />5'lYk--�-ke.� ne�,� v��' j�,-,��� �� r S�c�J CS��e,rr� r0 <br />Phone/�mail � C~r{ �i�� � C� � 2cj3 . �i �KJ - J2.J Z <br />BUILDING PERMIT APPLICATION <br />Existing Use ofBuilding <br />ONTRACT PRICE OF WORK <br />Proposed Use ofBuilding___ __ � Gas <br />Building type: _ Single Family _ Dupiex__Townhouse __ Multi-Family %� Commercial <br />Type ofproject: New Addition Remodel Repair T.I.�Sign__Sprinkler__D <br />DESCRIP110N �F WORK (addihonaispace provided on me back) :�-�r�C� �Q�� �e:{�f �,('�' <br />�-h� �ti�/ec:���+ ��-+ U � lz,� � Id ��� �. ��cc�c�� : I�tfer� �--�� �� be <br />L� D I � c�hi�s <br />MECHANICAL PERMIT APPLICATI�N <br />Type of Project: __New __Addn __Alteration __Repair <br />�how Phmlber {#f of fixtvres <br />A/C — air handling units <br />Forced air systems <br />Gas �iping <br />Water heater <br />Gas breplace <br />Gas range <br />Clothes dryer <br />Range hood <br />E�aust fan <br />Heat pump <br />Boiler <br />Refrigeration <br />Woodstove <br />Ducting <br />Other <br />SPRINKLER l SUPPRESSION SYSTEM <br />Number of Heads <br />HEAT SOURCE: <br />Electric �ther <br />emolitfon Change ofUse <br />� o� P�C.�i�G-� Or <br />I���m�nrx.fec� �,�.;ifl� <br />PLUMBING PERMIT APPLICATI�N <br />Type of Project: __New _Addn _Alteration __Repair <br />Show Ncrn�ber(#} offrxre�res <br />Toi let <br />B athtub <br />Lavatory (wash basin) <br />5 now er <br />Kitchen sink & disp <br />Dfstrwasher <br />Clothes washer <br />VVaterheater <br />Sink (servicePoar/m <br />Backflow preventer <br />Urinal <br />Urinking Fountain <br />Floor drain <br />Grease trap <br />R oof drains <br />Medical Gas <br />Other: <br />Other: <br />Iherebycertifythat Ihave read and examined tl'tis application and knowtYle same to betrue and correct.All provisions of laws and ordinances governing thistype ofwork vJill 6e complied <br />wdh Nihether specified herein or not. The granting of a permit does not presUme to give aUtY�orityto �iolate or cancel tY1e provision of any other state or local law regulating construction <br />Tha I au[horiZed bythe owner ofthls properLyto perform U�e work forwhich application is made and IcomplywitY� Che State Contractnrs Law 1827 RCW and 29E200A WAC. <br />l �� <br />►�. � � � � 2 � <br />Ownerf thori:ed Agent Signature ate (Revised 62092) <br />