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Dec, 24. 2015 9:16AM � � No, 1316 P. 2
<br />PERMIT APP�ICATION
<br />BUI�.QING/MEChIANICAL/l'LUMBING/SIGN/SPRINKLER/DEIVIOLITlON
<br />CIiY O� EVERE�'T P�RIIIIIT SEI�VICES
<br />320� Cedar Sf., Everetk, WA 95201 �425-257-8$10 F/�X 425-257-8II57 www.everettwa.org
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<br />�L for ncw co»siructlon: Short Plaflsuhdivia
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<br />ER �4"i �0�@ a�,.'t d'Ru�,. /�,1`i'�llr'�-x;,�, i
<br />�LIGANT: _ OWnef . Owner'g Agent /� Cuniiactof
<br />NTRACTOR �.1 c",:4' � �' ��� i, -�`il�t' T
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<br />VANT BUSINESS NAME
<br />DROPER TAX N PERMk7 �F
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<br />PE�unu/E-�nall
<br />BU�LDINC P�RMIT APPLtC,A,TION Icarvrwo,
<br />Gxisting Use of Building
<br />f'ro�7o58�3 Eisa of Ctuilding
<br />Quildin� fype: _ Single Fa11�iEy ,_ Duplex _Townhouse _ MulEf-`8mily
<br />Type of project; New Addifion Remodel Repair _ T.I.
<br />DESCRIPT(01� OF VIIORK (additiona! space provfUcd or� !he Dack) ;
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<br />PFZSC� OF WORK
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<br />_ Con�mercial
<br />n Sr�rinkler DerriUlltlOn {:I�anpo of Use
<br />MECHANICAL PeRMIT APFi�lCAT10� PLUMBING P�RMIT APPLICATION
<br />'T�+pe of Pr�JeCt: _Naw_AC1dn .� AItCYTllon _Re4>alr Type of ProjocL• „_,.,,Ncw_Adcln _niterstlon _Repair
<br />Shaw NumLer �F of ffxlures show Nrnnbcr (#) oi rr�ures
<br />NC � air handlin units 1"ol3et
<br />Forced air s stems k-��3tilUib
<br />Gas i in k..av�frif w8sh basin
<br />Wator heaYer Showe�
<br />Gas Firc lace Kitchen sink �$ diS )Usal
<br />Gas ran e Dishwasll�!r
<br />C14llles dr or Clothes washer
<br />12snqe hooc3 Water heater
<br />�xhaust fan Sink (service/barJmo /etc.
<br />Heat urn > i3ackflow preven#er
<br />iJr�it heater �l�lnal
<br />6oiler Dilnkir� Founlain
<br />Refri eration Floordfiln
<br />WoorJstove Grease tra
<br />!)ucliny l�oof drains
<br />Ofher Medical Gas
<br />SPRINKE.ER / SUPPRESSION SYSTEM . pti�er:
<br />NUrTtber of !-laads OEher.
<br />I Y1Bf9by Cofilly lhAt I h�Vr, �r;p! ;i��d exypiliietl Ihle eppllCellon end kiloW thr SlR1r. (U Iu` (1ur.:wd t:oilY.Cl. AI1 �fUV1610118 01 IdWB efld OfYIIf1c1f1G0o !7nvr,min9 (hi:: lyf�a uf wuik will Be compl
<br />wlth whothor snecifi��d }i,��nin ur nol. The grenllnp ot e permlt docs not pr�����m�e lu yive a�(hoiify to vlolate or cencei lhe pruviaion of �ny ulh�:r ��td�, u� lac:�,l Lyw iegulatiny co�ielnicllon
<br />That 1;mi :�uu�u�i�etl Uy Iltie owner ot Ihla proporty to pr�{n�i�t Iti�� woik for wldcli appllcalkon la made nnd I comply will� ih�: ;I:d�r CurHrycluie Law 18.z7 Cw end'1U6.zUUA AC.
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<br />OwnerlAutf�orizctl A�Cilt Slg��ature Dete (Revisr�d 9/2014)
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