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PERMIT APPLICATION <br />BUILDING nIIECI�ANICAL / PLUMBING / SIGN / S RINKLER / DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-8810 � FA}: 425-257-8857 �(E) everetteps@everettwa.gov � vww�.everettwa.gov/permits <br />BUILDING PERMIT APPLICATION <br />n Si�-! �i-' Contract Price of Work: $ 5'c���K� �� <br />Existing Use of Building: j� 1t' �- C>'� <br />Proposed Use of Building: _� � � ,� � � ,�r-� C+ Heat Source: ❑Gas ❑Electric ❑Other <br />Building Type: R-Detached ❑SFR-Attached ❑Duplex ❑Multi-Family-# of Units: �Commercial ❑Industrial <br />Type of Pro ect: ❑New ❑Addition ' emodel ClRepair ❑T.I. ❑Si n ❑Sprinkler ❑Demolition ❑Chan e of Use <br />DESCRIPTION OF WORK: �'� C'`��j,�x.� �`��c�<<� k�t�S° cit��/k� ,�cJ c.r��' <br />:l�c-•� r-�vncc�c>,�, {�c�rlc.'z c; � 1} 1�� c�c�lcl��iz,��c� �r- / %uy.:> ,,i;`1�',�>�r <br />�� I i'1 v r' �! � �/ ,;i , �/r�. i ,,.r n c � A'/i,i rw` r� � � • "' •' � � ,�j "��" � � <br />' �c'_ Ni�) - %c7Y�7r�• iL'•�l�k•7ZtGz� � J '�c' k.c/raa <N.T'h�S�-r;`Y- '�z' i.i`i t;l y'tY � � ��' <br />�''Y�� s rex : 7, luc�, � �i�• �L� %c� /n� � :A CG �Sy( n YLc <br />,r M 7 f <br />� ,,1 N1K�'i; u� - ;Iu� — rJc �; _, i. �t. G .. /Ys' c /� � ,� �� 7 C�y��w.1s,� � ✓', t�C�li� / _ `� r �` c ` ,q <br />ASSOCIATED BUILDING PERMIT # (if applicable): � ''� ` �� • y,s�yz� r - ' � c .�� f�tlG1 �Cic� ilUv� � ( y � <br />MECHANICAL PERMIT APPLICATIONI PWMBING PERMIT APPLICATION <br />Type of Project: _New _ Addn _Alteration _Repair Type of Project: _New _Addn _Alteration _Repair <br /># of List of Fixtures # of List of Fixtures # of List of Fixtures # of List of Fixtures <br />Fixtures Fixtures Fixtures Fixtures <br />A/C —Air Handling Units Heat Pump Toilet Backflow Preventer (Inside Bldg) <br />Forced Air Systems Unit HeatE�r Bathtub Urinal <br />Gas Piping Boiler Lavatory (Wash Basin) Drinking Fountain <br />Water Heater Refrigerat on Shower Floor Drain <br />Gas Fireplace Wood Sto�e i Kitchen Sink & Disposal Grease Trap <br />i Gas Range Ducting � Dishwasher Roof Drains <br />Clothes D er Hookups Other: Clothes Washer Medical Gas <br />� Range Hood Water Heater Other: <br />Exhaust Fan Sink (Service/Bar/Mop/etc.) Other: <br />SPRINKLER / SUPPRESSION SYSTEII� <br />Number of Heads <br />ACKNOWLEDGEMENT: 1 have reviewed this application and confinn the information contained herein is frue and correct. Work done pursuant to this permit must comply with <br />current federal, state, and local law. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authorized in writing from the <br />Building Official before being authorized under any circumstance. I am the owner, or I am aufhorized by the owner of this property to perform the work for which application is made. <br />and 1 comply with the State Contractors Law 18.27 RCW and 296.2C�OA WAC. <br />d Agent Signature <br />City of Everett OHicial Use Only <br />PERMIT # � � ( �� ��� <br />� .`� VJ <br />Date (Revised 10/12/2015) <br />�`� <br />