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� <br />PERMIT" APPL�CATION <br />BUILD1�11G/MECHANICAL/pLUMBING/SIGNISPRINKLER/DEMOLITION <br />CITY OF EVERETT pEI�MIT SERVICES <br />3200 Cedar St., Everett, WA 98207 425-257-8810 FAX 42�-257-8857 www.everetEwa.org <br />ROpE TY TAX ii PERMIT <br />��330�- c� 3 41��� I i <br />EQAL for neW construptloro: Short PIaUsUbdiviaion Lot Np� (attach copy of long leyal dssCtlption) <br />WN�Rs�'1 r \� � � t, � Phone/E-melll � � . �� � . "O � �'"1 <br />CANT: � owner _ owner's Agenk <br />a <br />City/State/Zip <br />COtI(r2Ct6r � COflffaClOi'�S A�ent � Tg�a�I (m�at provide a cestsr oT con&ent Rom the owner to do work in the 3pace) <br />s#aze t��c. # <br />�! <br />Phone/Emai� ' `�b - <br />F�R PERMIT � y�.�� t <br />PhpneJ�-m$i! � � iNil -L <br />IBUIlDING P�KMET APPLICATION C�N71zACT PRICE OF WC <br />Existiny Use of Building S <br />Proposed Use pf Building <br />BUilding type: �Sing1Q Family _ Duplex _Townhou _ Mulki-Famlly _ Commercial <br />1'ype of project: New Addition Remodet Repair T I Siqn Spri �nkler <br />D SCRIPTIQN OF WORK (addiiional space pr vrdsd on ha back : •,1 <br />C��l-� �� �.�.� ��� � A. s� � r n a�,c._ <br />1�.�,�`'� <br />MECHANICAL PERMy'X APPLICATI <br />�ype of Project: _jJew _Addn _qltentien � <br />Show NutnbBr (#) of fFrrureg <br />A/C — efr handlin units <br />Forced air s st¢ms <br />Gas i in <br />Water h�ater <br />Gas fir¢ laca <br />Gas ran e <br />Ciothes d er <br />Ran e hood <br />�xhaustfan <br />Neat um <br />Unit heatEr <br />Boiier <br />Refri eratjon <br />^„ WoodStove <br />�____ Ductinq <br />Other <br />SPRINKLER / SUPPRESSlON <br />_ Number of Heads <br />��rY eu5. ���. # ba e a o <br />-�8 •�Qo <br />HEAT SOURCE: <br />�as_ � . ��ectr3c Other <br />� <br />Demolition Change of U5e <br />. tir W � <br />PLUMBING �ERMIT APPLICATION <br />� T)/pe of Project: _New _qddn _�11�pra[iOn �„R¢paiY <br />Show N�m6er of fJxtureS <br />Toilet <br />Bathtub <br />Lavatory (wash basin) <br />TEM <br />& <br />washer <br />Urinal <br />Drinking Fountain <br />Flaor drain <br />Grease crap <br />Roof drains <br />Medical Gas <br />pther: <br />r <br />I hereBy cc�tiy that 1 have reea antl exaf„�nsd this apvl7catlon snd know the sam¢ to bs tr�s and coRect. All provisions of iawe and ordlnancaa yovern�ng tnie type of woHc wlll be comD <br />� h whether specttl�� hcrein or noi. 7�e granEfng oF a pvrmit does no[ Dresume to glve aufhori�y �o vio�at� or cancs� ihe provtsion ot any othar stste or iocal �aw r69ulaG�g construction <br />Tha i am authorized by Ihe own r of diis property ko perform tF,s wode for which pplicaiion ia mede end i comply with lhe Staf� Contraclar3 �,aw 18.27 RCW gntl 296.2D�A WAC. <br />� ` � �� � � � � E,�� <br />nerfAuthorltcd Agertt Signature pate � ((Revised 9f2016) <br />