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51 <br />• <br />� <br />PERMIT APPL.ICATIOt� <br />BUILDING/MECHANICALIPL.UMB��IGISICNISPRINKL.ER/DEMOL1TtON <br />CITY C3F EVERETT PERMlT SER1fiCES <br />3200 Cedar St., Everet#, WA 98201 425-257-$810 FAX 425-257-8857 www.everettwa.org <br />� � ,� - � <br />rax <br />�;.. <br />� {,. � � ���# �I� � <br />EGAL fQr new,constsuction: Shart PlaUsubdivisionT__ �Lot No. _�..,�_...__. (aitach capy of long legal descrpUon; <br />� <br />WNER ��t�._ Y � 9 a i � i � .�f� "L�� � � Rhone;E-mad �-� �'`�� .,�,,� _ ,� _ 4�-� �:�- �-� � <br />a~--- <br />jdress ':�� ` _ City/Stalel,Zip <br />PPLlCANT: � Owner i Owner's AgE?nt Contractor ____ Contractor's Agent � Tenart (mu,t P�ov�co a i�nv� nt co�se�: +usn, ine o�.mo{ ca eo �•,�rk ,n me <br />ONTRACTOR ,�iy�,,,,�,�-1 State Lic. # j�G.`1 City Bus. Lia #(,�� � <br />idress 0� „�. �-{.. � �,� PhnnelEmaii �p • � � g ' � �i� <br />ENANT BUSINESS IVAME CONTACT FOR PERMIT a� m� t ���-+r� <br />�U11.t�IMG PER11t��"�' AP'Pt�i+�AT[t;N <br />i i�i M'Yl's -�t._%�,�r 1.,4c1�r,. <br />PRICE OF WORK �r� .�� �': <br />Existing tJse af Building _ �. p�� � �� <br />Proposed Use of Bui - 9 <br />Building type: `� Single Family _v Duplex �Townfiouse � Multi- mily � Commercial <br />7ype oP project� New Addition Remndef Repair __� Siqn S rip nkEe <br />QESCR{PTION OF WORK (addir;onat spa� provided on the backJ : <br />� � � '"�i'� {".�,�. �_.� �� �`_:, ,�_��; , i �"�,'� �' C.._..,,�. <br />`�. <br />MECHANICAL PERMIT�APPLICATION <br />iype of ProjecY. _New _Addn �` Alteration _Repair <br />Show lYumber {�) of fixtures <br />A/C — air ttandiing uniEs <br />1 ; Forced air systems <br />� Gas piping <br />IWater heafPr <br />Gas range <br />Ciothes dry: <br />Range hooc <br />Exhaustfan <br />Neat purnR <br />f netraqerauon <br />l Woods#ove <br />I Ducting <br />i Other <br />NKI.ER / SUPPRESSION SYSTEM <br />Number of Heads <br />H�A"%DURCE <br />�� <br />' Etectric <br />Chanq� of Us� <br />P�UMBING PERMIT APPLICATION <br />of Project: _New _Addn ,_Atteration _Repair <br />Show Number (A`) of fixiures <br />Toilet <br />i EiathCub <br />Shawer <br />Kitchen sink 8 disqasal <br />Ctothes washer <br />\Nater heater <br />Back(iaw preventF <br />Urinai <br />Drinking Fot�ntain <br />Floor drain <br />Grease trap <br />Roof drairrs <br />Medical Gas <br />Qther: <br />Other: <br />I Fie�r4*by certily that 1 hav� read entl examfnt�d ihi5 appiie.atia�� and kn6w the san�e to be tr�:e and corrcct. Aki qtz�vis�ons ot 12ws and a�d'in8nces gotieming this tyge� o` wo�k +<vilt be comp <br />�� •h unether spzcif�e�7 herein or noL The grantmc� o' a permd does not pres�me ip yive authnrdy to v�atate cr r..ancel ;he provisian ot any atber staie vr Incai Iaw regviating construcGan <br />Tlt.a 1 ani autnonzed by ;he awn .r a� this property to per(orm tha work fpr w Ich apG��c lio,? is madc and 1 cc�r��p�y with the Siate Contractors t_aw 18 27 �2CLN and 29&200A WAC. <br />' ^ � ✓ � . �� <br />narlAuthorized Agent Signature ate (Revised 3/2094) <br />� <br />❑► <br />