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�� �ir—����� �a�ie��. <br />e <br />�utt��i�� ��ce�,����� � �M�t i��; ������c��� � ���o�rrio� <br />CITY OF CVERETT PERMIT SERVICES <br />3200 CEDAR STREET, EVERETT, WA 98201 <br />(P) 425-257-881D � 1=AX 425-257-8857 �(E) everetfeps@everettwa.gov � www.everettwa.gov/permits <br />COfdTAC7' IMFORMA'i'IOfd . <br />OWNER NAME: ��/%,V G � n -E� TENANT NAME (If Commercial): <br />OWNER MAILING ADDRESS: srRee <br />��7y STATE ZIP <br />OWNER PHONE: OWNER EMAIL: <br />CONTRACTOR NAME; <br />CONTRACTOR ADDRESS: srReEr <br />CITY STATE ZIP <br />CONTRACTOR PHONE: CONTRACTOR EMAIL: <br />CONTRACTOR LICENSE #(REQUIRED): CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR ❑ OTHER (Please Specify) <br />CONTACT NAME: CONTACT PHONE: <br />CONTACT EMAfL: <br />BUILDING PERMIT APPLICATION <br />Existing Use of Building: Contract Price of Work: $ <br />Proposed Use of Building: Heat Source: ❑Gas ❑Electric ❑Other <br />Building Type: ❑SFR-Defached ❑SFR-Aftached ❑Duplex ❑Multi-Family-# of Units: ❑Commercial ❑Industrial <br />Type of Project: ❑New ❑Addition ❑Remodel ❑Repair ❑T.I. ❑Sign ❑Sprinkler ❑Demolition ❑Change of Use <br />pESCRIPTION OF WORK: <br />�=�I. ��N� iNl.�� �i`���� �D ��7� . � n� .���,-� <br />� , � l , <br />ASSOCIATED BUILDING PERMIT #(if applicable): � 6 f � � <br />MECHANICAL PERMIT APPLIGATION <br />Type of Project: _New _ Addn _Alteration _Repair <br />Fi fu es List of Fixtures Fixtures List of Fixfures <br />A/C — Air Handling Unifs Heat Pump <br />Forced Air Sysfems Unit Heater <br />Gas Piping Boiler <br />Water Neater Refrigeration <br />Gas Fireplace Wood Stove <br />Gas Range Ducting <br />Clothes Dryer Hookups Other: <br />Range Hood <br />Exhaust Fan <br />SPRIRIKLEFi / SI�PPRESSION SYSTEM <br />Number of Heads <br />PLUMBING PERMIT APP TION <br />Type of Project: _New _Addn Altera ' _Repair <br /># of Lisf of Fixtures # of Lrst of Fixtures <br />Fixtures Fixfures <br />Toilet Backflow Preventer (Inside Bldg) <br />Bathfub Urinal <br />Lavatory (UUash Basin) Drinking Fountain <br />Shower Floor Drain <br />Kitchen Sink & Disposal Grease Trap <br />Dishwasher Roof Drains <br />Clothes Washer Medical Gas <br />Water Heater Other: <br />Sink (Service/BadMop/etc.) Other: <br />ACKNOWLEDGEMENT.' I have reviewed this applicafion and confirm the infonnafion contained herein is true and correci. Work done pursuant to this permit must comply with <br />cu�rent federal, state, and local law. The granting of a permit only authonzes approved work and no deviatrons therefrom. Deviatians must firsf be authoriz.ed in writing from the <br />Building Official before berng authorized under any circumstance. I am the owner, or l am authonzed by fhe owner of this property to perform the work for which application is made, <br />and / comply wifh the Stafe Contractors Law 18.27 RCW and 296.200A WAC. <br />z -2 � �-- l � <br />Own�r/Authorized l�yent Signature Date <br />City of Everetf Offcial Use Only <br />PERMIT ## � <br />r��,����� <br />(Revised 10/92/?_015) <br />31 <br />